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Reproductive Risk Factors and Prevalence of Cardiovascular-Kidney-Metabolic Syndrome among Young Women
Journal article   Open access   Peer reviewed

Reproductive Risk Factors and Prevalence of Cardiovascular-Kidney-Metabolic Syndrome among Young Women

Theresa Boyer, Allison W. Peng, Michael Fang, Timothy Chow, Amelia S. Wallace, Wendy Bennett, Erin D. Michos, Chiadi E. Ndumele, Elizabeth Selvin and Anum S. Minhas
American journal of preventive cardiology, Vol.26, 101432
04/2026
DOI: 10.1016/j.ajpc.2026.101432
PMID: 41630962
url
https://doi.org/10.1016/j.ajpc.2026.101432View
Published (Version of record) Open Access

Abstract

Introduction Cardiovascular-Kidney-Metabolic (CKM) syndrome provides a framework for early cardiometabolic and kidney dysfunction. While reproductive risk factors are associated with cardiovascular disease, their relationship to CKM syndrome stages remains unclear. We estimated CKM prevalence among reproductive-aged US women and evaluated associations with reproductive risk factors. Methods Using the National Health and Nutrition Examination Survey (2013-2020), we included 3,917 non-pregnant women aged 20-49 years. Reproductive risk factors included early menarche (≤10 years), infertility, gestational diabetes, delivery of a large-for-gestational-age neonate, and grand multiparity (≥ 5 births). CKM stages were classified as stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (metabolic risk factors or chronic kidney disease), stage 3 (subclinical cardiovascular disease), stage 4 (clinical cardiovascular disease). Adjusted prevalence ratios (aPRs) for CKM stage ≥ 2 were estimated using Poisson regression accounting for sociodemographic and behavioral factors. Results Approximately 34.7% (95% CI: 32.3, 37.1) of women reported at least one reproductive risk factor. Overall, 55.1% (95% CI: 52.9, 57.3) were classified as CKM stage ≥ 2. Women with reproductive risk factors were more likely to be in higher CKM stages. Significant associations with CKM stage ≥ 2 were observed for gestational diabetes (aPR, 1.25; 95% CI: 1.13, 1.39) and infertility (aPR, 1.14; 95% CI: 1.04, 1.26). Conclusion CKM syndrome is highly prevalent among reproductive-aged women in the US. Histories of gestational diabetes and infertility were associated with higher CKM stages. Incorporating reproductive factors into clinical tools could support targeted prevention of CKM progression and future CVD.
 Cardiovascular-kidney-metabolic syndrome Reproductive history Gestational diabetes Infertility Cardiometabolic health Women's health

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