Women who had more live births showed a lower risk of stroke and of covert brain damage, according to research co-led by UT Health San Antonio, the academic health center of The University of Texas at San Antonio. The study, "Number of Live Births as a Protective Factor Against Clinical and Covert Brain Infarcts: The Framingham Heart Study," was published April 7 in the Journal of the American Heart Association.
The finding runs against the folk wisdom that a large family wears down a mother's brain. Beyond clinical strokes, the researchers looked at covert infarcts - small areas of brain damage that show up on imaging without ever producing obvious symptoms. That type of quiet injury matters for cognition, since accumulated vascular damage is a well-recognized contributor to later thinking and memory problems.
Why it counts: more women than men have strokes, and the standard risk calculators clinicians use were not built around reproductive history. "Our findings would suggest that reproductive factors - for example, number of live births - may be an additional factor to consider when assessing stroke risk in women," said Sudha Seshadri, MD, behavioral neurologist and founding director of the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases at UT Health San Antonio, who is joint senior author with Emer R. McGrath, PhD, of the School of Medicine at the University of Galway in Ireland. Seshadri added that including this factor in female-specific prediction rules could sharpen how risk is estimated in women.
The work is an association drawn from the long-running Framingham Heart Study cohort rather than a test of cause and effect, and the practical payoff the researchers point to is refinement of stroke risk prediction tools for women rather than any change in care today.