Impact of grand multiparity on cardiac diastolic function and structure: A cross-sectional study in Iraqi women

A BSTRACT While numerous studies have investigated the impact of pregnancy on the cardiovascular system, the long-term alterations in heart structure and diastolic function among grand multiparous women remain under-researched, particularly in the context of contemporary guidelines and diagnostic techniques. This study aimed to investigate the alterations in left ventricular (LV) structure and diastolic function in multiparous women using echocardiography. Echocardiography was used to evaluate diastolic function and LV remodeling in 186 women with varying parity numbers. We compared echocardiographic parameters between parity groups: low parity (1–2 births) and grand multiparity (≥5 births). In the low parous group, 33 women (35.5%) had Grade 1 LV diastolic dysfunction (DD), and only 10 participants (10.8%) had Grade 2 or 3 DD. In women with grand multiparity, only 12 of them (12.9%) did not have DD, and 23 participants (24.8%) had Grade 2 or 3 DD. Logistic regression analysis indicates that any DD and Grade 2 or 3 DD have the highest percentage in the grand multiparity group, with 7.8 and 2.7 times greater than the low parous group, respectively. Grand multiparity but not low parity significantly deteriorates LV diastolic function according to the present study. Parity information must be evaluated when determining a cardiovascular risk in women. Additional research is necessary to assess the likelihood of progressive DD with each pregnancy and to determine if parity explains the higher risk of diastolic heart failure in women.