Table 1.
Summary findings for each reproductive risk factor and effect sizes for cardiovascular outcomes
| Reproductive factors (related to fertility) and fatality type | Effect size (95% CI) | |||
|---|---|---|---|---|
| Composite cardiovascular disease | Ischaemic heart disease | Stroke | Heart failure | |
| Early menarche | ||||
| Non-fatal | HR 1.15 (1.02 to 1.28) | — | — | — |
| Fatal | RR 0.99 (0.98 to 1.01) | RR 0.97 (0.95 to 0.99) | RR 0.98 (0.95 to 1.01) | — |
| Fatal and non-fatal | — | — | — | — |
| Oral contraceptive pill use | ||||
| Non-fatal | — | — | Ischaemic subtype, OR 2.47 (2.04 to 2.99) | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | Haemorrhagic subtype, OR 1.39 (1.05 to 1.83) | — |
| Current combined oral contraceptive use | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | Myocardial infarction, RR 1.6 (1.3 to 1.9) | Ischaemic subtype, RR 1.7 (1.5 to 1.9) | — |
| Progesterone only pill use | ||||
| Non-fatal | — | Myocardial infarction, RR 0.98 (0.66 to 1.47) | RR 1.02 (0.72 to 1.44) | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Combined oral contraceptives in obese women | ||||
| Non-fatal | — | Myocardial infarction, OR 0.88 to 5.1 | OR 0.59 to 4.6 | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Oestrogen containing contraceptives in women with migraine | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | Ischaemic subtype, OR 2.08 to 16.9 | — |
| Combined oral contraceptives in women with dyslipidaemia | ||||
| Non-fatal | — | Myocardial infarction, OR 25 (6 to 109) | IRR 1.76 (1.51 to 2.06) | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Combined oral contraceptives in women with hypertension | ||||
| Non-fatal | — | Myocardial infarction, OR 6 to 68 | Ischaemic subtype, OR 3.1 to 14.5 | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Combined non-oral hormonal contraceptives | ||||
| Non-fatal | — | Myocardial infarction, OR 0.2 to OR 1.6 | OR 0.8 to 1.2 | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Polycystic ovarian syndrome | ||||
| Non-fatal | OR 1.30 (1.09 to 1.56) | OR 1.44 (1.13 to 1.84) | OR 1.36 (1.09 to 1.7) | OR 3.24 (0.53 to 19.94) |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Fertility treatment | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | HR 0.91 (0.67 to 1.25) | — | HR 1.25 (0.96 to 1.63) | — |
| Parity | ||||
| Non-fatal | RR 0.79 (0.60 to 1.06) | — | — | — |
| Fatal | RR 1.14 (1.09 to 1.18) | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Breastfeeding | ||||
| Non-fatal | HR 0.77 to 0.93 | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Premature ovarian insufficiency | ||||
| Non-fatal | — | — | — | — |
| Fatal | RR 1.24 (0.98 to 1.58) | RR 1.48 (1.02 to 2.16) | RR 1.00 (0.86 to 1.16) | — |
| Fatal and non-fatal | HR 1.61 (1.22 to 2.12) | HR 1.69 (1.29 to 2.21) | HR 1.03 (0.88 to 1.99) | — |
| Early menopause (natural and unnatural) | ||||
| Non-fatal | — | RR 1.50 (1.28 to 1.76) | - | HR 1.36 to 1.66 |
| Fatal | RR 1.19 (1.08 to 1.31) | RR 1.11 (1.03 to 1.20) | RR 0.99 (0.92 to 1.07) | — |
| Fatal and non-fatal | — | — | — | — |
| Early natural menopause | ||||
| Non-fatal | — | — | — | — |
| Fatal | RR 1.01 (0.91 to 1.13) | RR 1.09 (1.00 to 1.18) | RR 0.94 (0.86 to 1.03) | — |
| Fatal and non-fatal | — | — | — | — |
| Menopausal symptoms | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | RR 1.29 (0.98 to 1.71) | RR 1.18 (1.03 to 1.35) | RR 1.08 (0.89 to 1.32) | — |
| Miscarriage | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | OR 0.83 to 2.69 | OR 1.45 (1.18 to 1.78) | OR 1.11 (0.72 to 1.69) | — |
| Stillbirth | ||||
| Non-fatal | OR 1.49 (1.08 to 2.06) | — | — | — |
| Fatal | OR 2.23 (1.90 to 2.62) | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Pre-eclampsia | ||||
| Non-fatal | OR 2.24 (1.72 to 2.93)*; OR 2.74 (2.48 to 3.04)† | OR 1.73 (1.46 to 2.06) | OR 2.95 (1.10 to 7.90) | RR 4.19 (2.09 to 8.38) |
| Fatal | OR 1.73 (1.46 to 2.06) | RR 2.10 (1.25 to 3.51) | RR 1.97(0.80 to 4.88) | — |
| Fatal and non-fatal | — | — | — | — |
| Recurrent pre-eclampsia | ||||
| Non-fatal | — | RR 2.40 (2.15 to 2.68) | RR 1.69 (1.21 to 2.35) | RR 2.88 (2.23 to 3.72) |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Gestational hypertension | ||||
| Non-fatal | RR 1.67 (1.28 to 2.19) | — | RR 1.83 (0.79 to 4.22) | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | — | — | — | — |
| Gestational diabetes | ||||
| Non-fatal | — | RR 2.09 (1.56 to 2.80) | RR 1.25 (1.07 to 1.48) | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | RR 1.98 (1.57 to 2.50) | — | — | — |
| Placental abruption | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | OR 1.82 (1.42 to 2.33) | — | — | — |
| Preterm birth | ||||
| Non-fatal | OR 1.63 (1.39 to 1.93) | RR 1.49 (1.38 to 1.60) | RR 1.65 (1.51 to 1.79) | — |
| Fatal | OR 1.93 (1.83 to 2.03) | RR 2.11 (1.87 to 2.36) | RR 1.30 (0.94 to 1.80) | — |
| Fatal and non-fatal | HR 2.01 (1.52 to 2.65) | HR 1.38 (1.22 to 1.57) | HR 1.71 (1.53 to 1.91) | — |
| Recurrent preterm birth | ||||
| Non-fatal | — | — | — | — |
| Fatal | HR 2.1 (1.2 to 3.7) | — | — | — |
| Fatal and non-fatal | HR 1.4 (1.2 to 1.6) | HR 1.4 to 1.8 | HR 1.8 (1.4 to 2.2) | — |
| Low birth weight | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | OR 1.29 (0.91 to 1.83) | — | — | — |
| Small for gestational age | ||||
| Non-fatal | — | — | — | — |
| Fatal | — | — | — | — |
| Fatal and non-fatal | OR 1.09 to 3.50 | — | — | — |
OR=odds ratio; HR=hazard ratio; RR=relative risk; IRR=incidence rate ratio.
*
Moderate pre-eclampsia.
†
Severe pre-eclampsia.