Workshop: The Long-Term Effects of Pregnancy on Aging

Purpose and Background

NIA’s Division of Aging Biology hosted the workshop, The Long-Term Effects of Pregnancy on Aging, in consultation with NIH’s Office of Research on Women’s Health and the Eunice Kennedy Shriver National Institute on Child Health and Development. The workshop was held on Nov. 1, 2023 from 8:00 a.m. to 6:30 p.m., ET. This workshop examined the state of the science on established and possible relationships between pregnancy and aging. It also explored the major research gaps and opportunities on the enduring effects of pregnancy on the health of parous women.

Speakers presented their research on the costs of reproduction on aging, how pregnancy affects the hallmarks and metrics of aging, and the effect of pregnancy complications. Participants added commentary to these presentations to encapsulate the scope of research questions regarding pregnancy and its relationship to aging. At the end of this workshop, an overarching discussion was held on existing knowledge gaps and areas of greatest need within this field of research.

Speaker List

  • Natalie A. Bello, MD, MPH, FACC, Cedars-Sinai Medical Center

    • Title: Preeclampsia: A Mechanistic Overview of Pathways Through Which this APO May Accelerate Cardiovascular Aging

  • Egle Bytautiene Prewit, MD, PhD, University of Texas Health San Antonio

    • Title: Lactation, Oxytocin, and Maternal Aging

  • Liisa A. M. Galea, PhD, University of British Columbia

    • Title: Previous Parity Alters the Trajectory of Brain Aging

  • Vadim Gladyshev, PhD, Harvard Medical School

    • Title: Quantifying Biological Age in the Context of Reproduction

  • Grazyna Jasienska, MSc, MA, PhD, Jagiellonian University

    • Title: The Long-Term Costs of Reproduction in a High Fertility Population

  • Kara McKinley, PhD, Harvard University

    • Title: Costs of Reproduction from a Uterine Perspective

  • Eliza C. Miller, MD, MS, Columbia University

    • Title: Adverse Pregnancy Outcomes and Vascular Cognitive Impairment: Clinical Perspective

  • W. Tony Parks, MD, University of Toronto

    • Title: The Relation of Placental Pathology to Later Life Cardiovascular Disease in Women

  • Anna Z. Pollack, PhD, MPH, George Mason University

    • Title: Forever Chemicals and Endometriosis

  • Janet Rich-Edwards, ScD, MPH, Harvard Medical School

    • Title: The Chicken or the Egg? Cautions on Cause and Correlation

  • Calen P. Ryan, MSc, MA, PhD, Columbia University

    • Title: Cross-Sectional and Longitudinal Changes in Gravidity are Associated with Accelerated Epigenetic Age in Young and Middle-Aged Women in the Philippines

  • Jaime Slaughter-Acey, PhD, MPH, The University of North Carolina at Chapel Hill

    • Title: Systemic Influences on Pregnancy and Aging: A Health Equity Lens

  • Anna E. Stanhewicz, PhD, University of Iowa

    • Title: Gestational Diabetes and Future Cardiovascular and Metabolic Health

  • Yousin Suh, PhD, Columbia University (*workshop co-chair)

    • Title: Molecular, Cellular, and Genetic Signatures of Reproduction in Women

  • J. Paula Warrington, PhD, FAHA, The University of Mississippi Medical Center

    • Title: Modelling Long-Term Postpartum Neurological Disorders after Pregnancy Complications in Preclinical Studies

Executive Summary

The Long-Term Effects of Pregnancy on Aging workshop was convened on November 1, 2023, by the Division of Aging Biology of the National Institute on Aging ( NIA ), in consultation with the National Institute of Health's Office of Research on Women's Health ( ORWH ), and the Eunice Kennedy Shriver National Institute on Child Health and Development ( NICHD ). The purpose of this workshop was to examine the state of the science on established and possible relationships between pregnancy and aging, identify gaps in current knowledge, and identify research opportunities to further our understanding of the relationship between pregnancy and aging.

During the three scientific sessions, invited speakers from a wide range of biological and social research communities summarized the current research landscape, discussed their findings, and presented scientific priorities of their relevant research areas, with focuses on:

  • the biological costs of reproduction on aging
  • the effects of pregnancy on selected hallmarks and metrics of aging, and
  • the effects of gestational period length and adverse pregnancy outcomes (APO) on future maternal health.

In the final session of the workshop, speakers and meeting participants discussed the need to develop interventions (pharma and/or lifestyle) targeting biological age of the female reproductive system and translate research findings into clinical practice. They also identified various gaps and future directions for aging research on parous women, including:

  • Support mechanistic/validation studies to better understand aging of the female reproductive system and develop appropriate models (cells, animals, and others) to recapitulate human aging physiology and study basic science of the biological effects of reproduction on aging,
  • Develop robust biomarkers of biological age for reproductive systems such as the ovarian epigenetic aging clock, and non-invasive methods to diagnose diseases of the reproductive systems and quantify biological aging of reproductive systems and fetuses, e.g., based on blood analyses,
  • Better define and assess origin of pregnancy effects on aging (such as heterogeneity-between tissues and at the organismal level, changes in metabolic trajectories, characteristics of pregnancy, etc.),
  • Leverage existing and emerging large-scale human genetic, genomic, and epigenomic data to identify and develop hallmarks of reproductive aging,
  • Enhance study design by developing controls and conducting longitudinal pre-clinical and clinical studies on the long-term effects of pregnancy on aging, integrate reproductive and obstetric history in aging cohort studies, and identify intervention windows to mitigate the consequences of APOs in later maternal life, and
  • Expand research and treatment to underserved and understudied populations, include measures of social risk and protections and more diverse human ecologies (support systems, childcare, partners, etc.), and conduct research on how pregnancy modifies/interacts with social-structural determinants of health and health equity in the aging trajectory.

For the full Workshop Summary report, please contact Katherine Kim ( Katherine.Kim@nih.gov ).

NIH Organizing Committee

  • Stacy Carrington-Lawrence, PhD, National Institute on Aging
  • Elena K. Gorodetsky, MD, PhD, NIH Office of Research on Women's Health
  • Katherine I. Kim, MA, National Institute on Aging
  • Ronald A. Kohanski, PhD, National Institute on Aging (*retired in December 2023)
  • Fei Wang, PhD, National Institute on Aging (*workshop co-chair)

Contact Information

Please contact Katherine Kim for questions you may have about the workshop.