2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T583,Female-specific reproductive factors have been associated with stroke risk, although evidence for some factors (eg, live births) remains conflicting. We determined the association between number of live births and other female-specific reproductive factors and subsequent risk of stroke and magnetic resonance imaging markers of vascular brain injury in a community-based cohort. This was a prospective cohort study of 1882 (mean age, 61.3±9.6 years) women from the FHS (Framingham Heart Study) Offspring cohort who were stroke free at the baseline examination (1998-2001). Reproductive factors included number of live births, age at menopause, postmenopausal hormone replacement therapy use and serum estradiol and estrone levels. The primary outcome was incident all-cause stroke, with covert brain infarcts and white matter hyperintensity volume on brain magnetic resonance imaging as cross-sectional secondary outcomes. During a median 18-year follow-up, 126 women had a stroke. On multivariable Cox proportional hazards models controlling for vascular risk factors, ≥3 live births (versus 0, reference) was associated with a reduced risk of stroke (hazard ratio, 0.51 [95% CI, 0.31-0.85]; A greater number of live births was associated with a decreased risk of stroke and covert brain infarct in women and may be an important factor to include in female-specific clinical prediction rules for stroke.31:Ta70, Background Female‐specific reproductive factors have been associated with stroke risk, although evidence for some factors (eg, live births) remains conflicting. We determined the association between number of live births and other female‐specific reproductive factors and subsequent risk of stroke and magnetic resonance imaging markers of vascular brain injury in a community‐based cohort. Methods This was a prospective cohort study of 1882 (mean age, 61.3±9.6 years) women from the FHS (Framingham Heart Study) Offspring cohort who were stroke free at the baseline examination (1998–2001). Reproductive factors included number of live births, age at menopause, postmenopausal hormone replacement therapy use and serum estradiol and estrone levels. The primary outcome was incident all‐cause stroke, with covert brain infarcts and white matter hyperintensity volume on brain magnetic resonance imaging as cross‐sectional secondary outcomes. Results During a median 18‐year follow‐up, 126 women had a stroke. On multivariable Cox proportional hazards models controlling for vascular risk factors, ≥3 live births (versus 0, reference) was associated with a reduced risk of stroke (hazard ratio, 0.51 [95% CI, 0.31–0.85]; P <0.01). More live births (≥3 versus 0) was cross‐sectionally associated with decreased risk of covert brain infarct (odds ratio, 0.52 [95% CI, 0.30–0.92]; P =0.03). No significant association was detected between other reproductive factors and incident stroke or magnetic resonance imaging markers of vascular brain injury. Conclusions A greater number of live births was associated with a decreased risk of stroke and covert brain infarct in women and may be an important factor to include in female‐specific clinical prediction rules for stroke. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Reproductive Risk Factor Assessment: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Reproductive Risk Factor Assessment (modality). Clinician-written summaries and actionable practice insights. 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On multivariable Cox proportional hazards models controlling for vascular risk factors, ≥3 live births (versus 0, reference) was associated with a reduced risk of stroke (hazard ratio, 0.51 [95% CI, 0.31-0.85]; ","abstract":"$30","keywords":["reproductive factors","risk prediction","stroke","women"],"pubmed_id":"41848034","conclusions":"","publication_date":"2026-03-18T00:00:00"},"crossref":{"DOI":"10.1161/jaha.125.044037","URL":"https://doi.org/10.1161/jaha.125.044037","ISSN":["2047-9980"],"link":[{"URL":"https://www.ahajournals.org/doi/full/10.1161/JAHA.125.044037","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"7","score":1,"title":["Number of Live Births as a Protective Factor Against Clinical and Covert Brain Infarcts: The Framingham Heart Study"],"author":[{"given":"Senan","family":"Maher","sequence":"first","affiliation":[{"name":"University of Galway"}]},{"given":"Matthew R.","family":"Scott","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study"},{"name":"Boston University Chobanian & Avedisian School of Public Health"}]},{"given":"Rachel F.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"},{"name":"Brigham and Women’s Hospital"},{"name":"Melbourne School of Psychological Science and Florey Institutes, University of Melbourne"}]},{"given":"Charles S.","family":"DeCarli","sequence":"additional","affiliation":[{"name":"University of California"}]},{"given":"Hugo J.","family":"Aparicio","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study"},{"name":"Boston University Chobanian & Avedisian School of Medicine"}]},{"given":"Jose Rafael","family":"Romero","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study"},{"name":"Boston University Chobanian & Avedisian School of Medicine"}]},{"given":"Ramachandran S.","family":"Vasan","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study"},{"name":"University of Texas School of Public Health San Antonio"},{"name":"University of Texas Health Science Center"},{"name":"University of Texas Health Science Center"}]},{"given":"Joanne M.","family":"Murabito","sequence":"additional","affiliation":[{"name":"Boston University Chobanian & Avedisian School of Medicine"}]},{"given":"Shalender","family":"Bhasin","sequence":"additional","affiliation":[{"name":"Research Program in Men’s Health, Aging and Metabolism, Department of Medicine, Boston Claude D. 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Cohort Study","value_numeric":null},{"paper_doi":"10.1161/jaha.125.044037","tag_type":"warning","value":"Cross-sectional MRI outcomes preclude causal inference for covert brain infarcts and white matter hyperintensity volume.","value_numeric":null},{"paper_doi":"10.1161/jaha.125.044037","tag_type":"warning","value":"The cohort is predominantly White (Framingham), so findings may not generalize to diverse populations.","value_numeric":null},{"paper_doi":"10.1161/jaha.125.044037","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — this is an observational study and causality is not established; findings support inclusion of parity in risk models but require validation before clinical adoption.","value_numeric":null}],"summaries":{"what_studied":"This prospective cohort study examined whether number of live births and other female reproductive factors (age at menopause, hormone replacement therapy use, serum estradiol/estrone levels) were associated with incident stroke and MRI markers of vascular brain injury in 1,882 stroke-free women (mean age 61.3 years) from the Framingham Heart Study Offspring cohort, followed over a median 18 years (baseline 1998–2001).","key_result":"Having ≥3 live births (vs. 0) was associated with a 49% lower risk of incident stroke (HR 0.51, 95% CI 0.31–0.85) and a 48% lower odds of covert brain infarct on MRI (OR 0.52, 95% CI 0.30–0.92); 126 women had a stroke during follow-up. No significant associations were found for menopause timing, HRT use, or estrogen levels.","limitations":"- Observational design limits causal inference; residual confounding cannot be excluded.\n- Reproductive data were self-reported, introducing potential recall bias.\n- The cohort is predominantly White community-dwellers (Framingham), limiting generalizability to other racial/ethnic groups.","practice_takeaway":"Parity (≥3 live births) may be a protective factor worth including in female-specific stroke risk prediction tools. Clinicians assessing stroke risk in women should routinely ask about reproductive history, including number of live births."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Reproductive Risk Factor Assessment"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Reproductive Risk Factor Assessment"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Reproductive Risk Factor Assessment"}}}]]

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