Teen childbirth linked to increased cardiovascular risk decades later

Teenage mothers could face significantly more cardiovascular risk later in life than women who become first-time mothers at older ages, according to new research in the Journal of the American Heart Association.

Catherine Pirkle, PhD, and colleagues collected data from 1,047 women ages 64 to 75 living in Canada, Albania, Colombia and Brazil. Those who gave birth before turning 20 scored an average of 5.6 points higher on the Framingham Risk Score (FRS) than women who gave birth for the first time from ages 25 to 29—the lowest-risk age group. The FRS is commonly used to estimate 10-year cardiovascular risk.

“Adolescent mothers may need to be more careful about lifestyle factors that increase the risk of cardiovascular disease, including maintaining a healthy body weight and sufficient physical activity,” Pirkle said in a press release. “Clinicians may need to pay more careful attention to women’s reproductive characteristics, and more intensive screening of cardiovascular-disease risk may be required of women reporting early childbirths.”

Among women with children, the number of lifetime births didn’t significantly affect cardiovascular risk—which is in contrast to previous studies. However, women who had never given birth at all showed the lowest risk.

“Pregnancy has been described as a physiological ‘stress’ test,” the researchers wrote. “Although some of the nulliparous women in our sample may have miscarried or terminated pregnancies, as a group, they would have experienced dramatically lower mean levels of pregnancy-related complications and no, or much shorter, durations of stress tests on the body. These findings potentially explain the lower mean FRSs observed in the nulliparous group.”

Of the 188 women who reported childbirth in their teens, 68.1 percent were from Latin American sites. Women who became mothers before age 20 were also more likely to face childhood economic and social adversity, have lower educational attainment and have less income.

The study relied on self-reports from older participants who could be affected by memory loss, but all the women were tested for dementia. A more impactful limitation of the research, according to Pirkle et al., is many high-risk, young mothers from the poorer countries may not have survived to the point of study inclusion, potentially limiting the power of the findings.

“If adolescent childbirth increases the risk of cardiovascular disease risk, then our findings reinforce the need to assure that girls and adolescents have sufficient sexual education and access to contraception to avoid adolescent childbearing in the first place,” Pirkle said. “If the association is mediated by lower educational attainment, poorer health behaviors and other factors caused by young motherhood, then our findings also suggest a need to provide more support to young mothers.”