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Original research article
Women’s reproductive factors and incident cardiovascular disease in the UK Biobank
  1. Sanne AE Peters1,
  2. Mark Woodward1,2,3
  1. 1 The George Institute for Global Health, University of Oxford, Oxford, UK
  2. 2 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  3. 3 Department of Epidemiology, John Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Sanne AE Peters, The George Institute for Global Health, University of Oxford, Oxford, OX1 3QX, UK; sanne.peters{at}


Background Studies have suggested that women’s reproductive factors are associated with the risk of cardiovascular disease (CVD); however, findings are mixed. We assessed the relationship between reproductive factors and incident CVD in the UK Biobank.

Methods Between 2006 and 2010, the UK Biobank recruited over 500 000 participants aged 40–69 years across the UK. During 7 years of follow-up, 9054 incident cases of CVD (34% women), 5782 cases of coronary heart disease (CHD) (28% women), and 3489 cases of stroke (43% women) were recorded among 267 440 women and 215 088 men without a history of CVD at baseline. Cox regression models yielded adjusted hazard ratios (HRs) for CVD, CHD and stroke associated with reproductive factors.

Results Adjusted HRs (95% CI) for CVD were 1.10 (1.01 to 1.30) for early menarche (<12 years), 0.97 (0.96 to 0.98) for each year increase in age at first birth, 1.04 (1.00 to 1.09) for each miscarriage, 1.14 (1.02 to 1.28) for each stillbirth, and 1.33 (1.19 to 1.49) for early menopause (<47 years). Hysterectomy without oophorectomy or with previous oophorectomy had adjusted HRs of 1.16 (1.06 to 1.28) and 2.30 (1.20 to 4.43) for CVD. Each additional child was associated with a HR for CVD of 1.03 (1.00 to 1.06) in women and 1.03 (1.02 to 1.05) in men.

Conclusions Early menarche, early menopause, earlier age at first birth, and a history of miscarriage, stillbirth or hysterectomy were each independently associated with a higher risk of CVD in later life. The relationship between the number of children and incident CVD was similar for men and women.

  • cardiovascular disease
  • women
  • menarche
  • parity
  • pregnancy complications
  • hysterectomy
  • oophorectomy
  • menopause
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  • Contributors SP and MW conceived the study, interpreted the data, and approved the final version of the manuscript. SP conducted the statistical analyses and prepared the first draft of the manuscript, which was critically revised by MW.

  • Funding SP is supported by a UK Medical Research Council Skills Development Fellowship (MR/P014550/1). MW is supported by a NHMRC Fellowship (APP108026).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval UK Biobank has obtained Research Tissue Bank approval from its governing Research Ethics Committee, as recommended by the National Research Ethics Service. No separate ethics approval was required. The study was conducted in accordance with the principles of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Researchers can apply to use the UK Biobank resource and access the data used. No additional data are available.

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