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Background  Previous studies observe associations between lifetime parity and cardiovascular disease, but relatively fewer investigate age at first childbirth ( AFB ). Herein, we examine the association of  AFB  with a summary cardiovascular risk measure (Framingham Risk Score [ FRS ]).    Methods and Results  As part of the IMIAS (International Mobility in Aging Study), data were collected in 2012 among 1047 women, aged 65 to 74 years, from Canada, Albania, Colombia, and Brazil.  FRSs  were calculated to describe cardiovascular risk profiles, and linear regression analyses were performed, adjusting for early life and socioeconomic variables. Women with an AFB of <20 years were compared with women with an  AFB  of 20 to 24, 25 to 29, and ≥30 years, as well as nulliparous women. We also compared  FRS  between combinations of  AFB  and parity categories: nulliparous women, parity 1 to 3 combined with  AFB  <20 years, parity ≥4 with  AFB  <20 years, parity 1 to 3 with  AFB  ≥20 years, and parity ≥4 with  AFB  ≥20 years. Women with an  AFB  of <20 years had a higher mean  FRS  compared with all other  AFB  groups. Compared with the lowest  AFB  risk group (25–29 years), women with an  AFB  of <20 years had a 5.8‐point higher mean  FRS  (95% confidence interval, 3.4–8.3 points). Nulliparous women presented the lowest mean  FRS  in all analyses. The analysis comparing combinations of  AFB  and parity categories showed no meaningful differences in  FRS  between women who had 1 to 3 childbirths and those who had ≥4 childbirths within the stratum of  AFB  <20 years, and in the stratum of  AFB  ≥20 years.    Conclusions  Our analyses suggest that nulliparity and  AFB , rather than increasing parity, drive the association with cardiovascular disease risk.

journal of the american heart association

Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study)