ESC Congress 2026 Abstract · Oct 26, 2026

Children change your heart: association between childbirth and long-term changes in cardiac structure and function:

By Shalowitz E, Sompel K, Leyba K et al.

Background: Evidence from multiple observational cohorts has suggested that each live birth increases the long-term risk of incident heart failure (HF) in women as well as earlier age of HF diagnosis. The impact of delivering multiple children on cardiac structure prior to onset of HF is unknown. Methods: Data from the Atherosclerosis Risk in Communities (ARIC), Cardiovascular Health Study (CHS), Framingham Heart Study (FHS), Jackson Heart Study (JHS), and Multiethnic Study of Atherosclerosis (MESA) comprising were obtained from the NHLBI’s BioLINCC resource. Since echocardiography was not performed at each visit, data were extracted from ARIC visit 5, CHS visit 5, FHS Original visit 16, Offspring visit 8, Omni 1 visit 3, Generation 3/Omni 2/Offspring Spouse baseline visit, JHS baseline visit, and MESA visit 5. Post menopausal women who had not developed heart failure at the time of echo were analyzed. Number of liveborn children was determined from reproductive history data. We analyzed groups of women with 0,1,2,3, and 4+ children. Results: Echocardiographic characteristics are summarized according to number of liveborn children in Table 1. Although all women were post-menopausal and did not have a diagnosis of HF, women with more children were older at time of echo. Women with more children had a higher rate of incident HF and earlier age of HF onset. Systolic function decreased significantly with having more children by for the left ventricle and nominally for the right ventricle. Increasing number of children was associated with decreased LV chamber volume and increased RV area. Both E/A ratio and mitral valve deceleration time were increasingly abnormal with increased children. Estimated LV filling pressure using lateral E/e’ ratio was significantly higher with more children. Conclusion: In this aggregated, diverse cohort of women, increasing number of liveborn children was associated with adverse changes in systolic, and diastolic function prior to the onset of HF, whereas trends in structural changes were less clear. Understanding the mechanism by which childbirth impacts cardiac function decades later may identify opportunities to mitigate this risk.Echo characteristics vs. number of children

doi.org/10.1093/eurheartj/ehag785.3752Open accessPopulations