Reproductive history and physical functioning in midlife: The Bogalusa Heart Study.

objectiveTo examine the relationship between reproductive history, pregnancy complications, and later physical function. STUDY

designThe Bogalusa Heart Study is a long-running study of cardiovascular health in a semirural community. 761 women were interviewed about their pregnancy history and complications, and underwent tests of physical function. Logistic models for dichotomous outcomes and linear models for continuous outcomes were used, adjusted for covariates.

main outcome measuresOverall scores on the Short Physical Performance Battery (SPPB), which combines scores for balance, gait speed, and chair stands. Additional tests were a 6-min walk, knee extension strength, grip strength, and a pegboard challenge.

resultsNulliparity was associated with lower scores on the walking and balance portions of the SPPB, less distance covered in the 6-min walk, less knee and grip strength, and higher pegboard time, especially among pre-menopausal women. A history of gestational diabetes was associated with more problems on the walk portion of the SPPB (aOR 2.44, 1.06-5.65), higher chair stand time, and lower knee strength. Young age at first birth (<16 or 18 years) was associated with a shorter chair stand time and a better pegboard score.

conclusionsNulliparity was associated with worse physical functioning, while high parity and early pregnancy were not, suggesting that fertility is associated with better health later in life. Pregnancy complications were associated with worse physical functioning, even after controlling for body mass index. Future studies should attempt to establish the pathways by which reproductive health relates to overall physical functioning.