# Effect of reproductive history on longitudinal change in cardiac, vascular and lipid parameters

> **NIH NIH R01** · CINCINNATI CHILDRENS HOSP MED CTR · 2024 · $683,122

## Abstract

Abstract
Pregnancy is often described as a physiologic “stress test” that may uncover latent risk for
hypertension, diabetes and CVD. Even in uncomplicated pregnancies, women experience rapid
cardiometabolic changes to support fetal development. While many of these adaptations
normalize soon after delivery, some changes persist, including echocardiographic changes in
cardiac structure and lower high-density lipoprotein cholesterol (HDL-C). Whether these
pregnancy-related changes, or alterations in HDL particle structure or function, contribute to
long-term cardiovascular risk is unknown. Parity, or the total number of live births, among post-
menopausal women is also associated with greater risk of cardiovascular disease and
alterations in HDL-C levels, HDL structure and function, and cardiac and vascular function.
However, a significant research gap exists in linking observed cardiovascular changes across
pregnancy to the observed associations of parity with cardiovascular health post-menopause.
We will address this gap by leveraging existing data and samples from the NHLBI Growth and
Health Study (NGHS) and conduct a new in-person visit in 350 participants at median age 46,
when the women will be pre- or peri-menopausal. NGHS enrolled 871 girls (50% African-
American and 50% white) in 1987 at age 9 or 10 and examined them up to 17 times, to age 27,
including 7 echocardiograms between ages 20-27, multiple saved samples and reproductive
history questionnaires. This study will conduct detailed lipoprotein sizing and functionality
assessments from stored and new samples and conduct cardiovascular imaging and repeat
echocardiograms at median age 46 to: 1) Determine the specific lipoprotein particle size
distribution and function changes which occur from before to short- and long-term post
pregnancy; 2) Determine whether pregnancy-related cardiac adaptations result in long-term
alterations in cardiac structure and function, thereby increasing CVD risk for women in their
forties; and 3) Test whether parity increases CV risk independently of socioeconomic status
(SES) in African-American and white women. With the completion of our aims, we will have
determined the prospective pathways between pregnancy-related lipoprotein and cardiovascular
changes and pre-menopausal cardiovascular health for women in their forties. Results from our
proposed studies will fill a critical gap in our understanding of how such risks may accumulate
during a woman's reproductive life, as well as how socioeconomic status contributes to parity-
related risk long-term. Women in this study have also been exposed to the obesity epidemic,
lending greater understanding to contemporary reproductive development.

## Key facts

- **NIH application ID:** 10744237
- **Project number:** 5R01HL158100-03
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Elaine Mott Urbina
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $683,122
- **Award type:** 5
- **Project period:** 2021-12-01 → 2026-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10744237

## Citation

> US National Institutes of Health, RePORTER application 10744237, Effect of reproductive history on longitudinal change in cardiac, vascular and lipid parameters (5R01HL158100-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10744237. Licensed CC0.

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