Is pregnancy loss associated with later cardiovascular disease?

January 01, 0001

Is pregnancy loss associated with later cardiovascular disease?

These German researchers looked at whether pregnancy loss is linked with a higher risk of subsequent myocardial infarction (MI) and stroke. They performed a prospective cohort study using the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort in Heidelberg, Germany. Mean follow up was approximately 11 years.

The researchers found: "Out of the participants, 2876 (25%) had at least one miscarriage, 2053 (18%) had at least one abortion and 209 (2%) had at least one stillbirth. During the follow-up, 82 cases of MI and 112 of stroke (confirmed by medical records) occurred in these women. Each stillbirth increased the risk of MI 2.65 times (HR adjusted for age, smoking, alcohol consumption, body mass index, waist to hip ratio, physical activity, education, number of pregnancies, hypertension, hyperlipidaemia and diabetes mellitus: HR 2.32). Recurrent miscarriage (>3) was associated with about nine times higher risk of MI (age-adjusted HR=8.90, fully adjusted HR 5.06). No significant association was found between abortion and MI or between any type of pregnancy loss and stroke."

The researchers concluded: "These results suggest that women who experience spontaneous pregnancy loss are at a substantially higher risk of MI later in life. Recurrent miscarriage and stillbirth are strong sex-specific predictors for MI and thus should be considered as important indicators for cardiovascular risk factors monitoring and preventive measures. Further research is suggested to elucidate underlying risk factors of pregnancy loss that at the same time strongly predispose to cardiovascular disease."

This study suggests that recurrent spontaneous pregnancy loss is an important indicator of cardiovascular risk, although further study is warranted.

For the full abstract, click here.

Heart 97(1):49-54, 1 January 2011 © 2011 BMJ Publishing Group Ltd & British Cardiovascular Society
Pregnancy loss and risk of cardiovascular disease: a prospective population-based cohort study (EPIC-Heidelberg). Elham Kharazmi, Laure Dossus, Sabine Rohrmann, Rudolf Kaaks. Correspondence to Elham Kharazmi: [email protected], [email protected]

Category: K. Circulatory, W. Pregnancy, Family Planning. Keywords: miscarriage, abortion, stillbirth, pregnancy loss, myocardial infarction, prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 8 February 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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