Number of Pregnancies and Risk of Cardiovascular Disease

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Abstract
In their study of the relation between the number of pregnancies and the risk of cardiovascular disease (May 27 issue), Ness et al. found that having six or more pregnancies was associated with a small but consistent increase in the risk of coronary heart disease and cardiovascular disease1. The authors state that their findings have been adjusted for educational level but do not specify the statistical method used. Were high-school years and elementary-school years weighted equally? The educational level of the subgroup with six or more pregnancies was significantly lower than that of the other subgroups in both the Framingham Heart Study and the National Health and Nutrition Examination Survey National Epidemiologic Follow-up Study (NHEFS). The chief difference was in the percentage of women who attended high school. There is an association between educational level and the risk of coronary artery disease2,3. The assertion that multigravidity is associated with an increased risk of cardiovascular disease may just be a reassertion of an already established concept.