Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study

Smith, Gordon C. S.; Wood, Angela; Pell, Jill P.; Hattie, Joanne

doi:10.1111/j.1471-0528.2010.02890.x

Cited by 47 publications

(38 citation statements)

References 19 publications

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“…6 The large (>10 000 women) European Prospective Investigation Into Cancer and Nutrition-Heidelberg cohort also reported significant associations between pregnancy loss and myocardial infarction but no significant associations with stroke, although this study had only a limited number of events and conclusions were limited by a self-reported history of pregnancy loss and a participation rate of 40%. 7 Our findings suggest an etiologic link between pregnancy loss and atherosclerotic outcomes, with these disparate events connected either by pathological processes initiated by a miscarriage or stillbirth that then lead to atherosclerosis or by common underlying mechanisms, possibly with genetic underpinnings.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, the recent finding of Smith and colleagues 6 of an association between a parental history of ischemic heart disease and recurrent miscarriage in daughters (an association that was robust to adjustment for socioeconomic deprivation and smoking among other potential confounders) is of particular interest, suggesting as it does a possible genetic link between the 2 conditions. Previous studies of the associations between pregnancy losses and risk of ischemic heart disease and stroke have had limited possibilities for examining these associations specifically among younger women 4,7,24 ; examining 3 different atherosclerotic end points, we found the strongest associations with miscarriages in the youngest women.…”

Section: Discussionmentioning

confidence: 99%

“…An association between early pregnancy loss before first live birth and increased risk of ischemic heart disease has been reported, 4 and a study linking endothelial dysfunction with adverse pregnancy events supplied a possible underlying mechanism. 5 Recently, links have been reported between a parental history of ischemic heart disease and recurrent miscarriage before first live birth 6 and between self-reported number of pregnancy losses and later risk of myocardial infarction. 7 However, studies that also examined stroke risk were unable to demonstrate an association between pregnancy loss and stroke.…”

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Pregnancy Loss and Later Risk of Atherosclerotic Disease

et al. 2013

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Denmark has universal free public health care, and all hospital contacts are registered in national health registers. Since April 1, 1968, the Danish Civil Registration System 8 has assigned a unique personalBackground-Pregnancy losses and atherosclerotic disease may be etiologically linked through underlying pathology. We examined whether miscarriage and stillbirth increase later risk of myocardial infarction, cerebral infarction, and renovascular hypertension. Methods and Results-Among women pregnant at least once between 1977 and 2008, we identified a cohort of women with miscarriages, stillbirths, or live singleton births. These women were followed from the end of pregnancy for incident myocardial infarction, cerebral infarction, and renovascular hypertension. Using Poisson regression, we estimated incidence rate ratios for each of the outcomes by history of miscarriage and stillbirth. Among 1 031 279 women followed for >15 928 900 person-years, we identified 27 98 myocardial infarctions, 40 53 cerebral infarctions, and 1269 instances of renovascular hypertension. Women with stillbirths had 2.69 (95% confidence interval, 2.06-3.50), 1.74 (1.32-2.28), and 2.42 (1.59-3.69) times the rates of myocardial infarction, cerebral infarction, and renovascular hypertension, respectively, as women with no stillbirths. Compared with women with no miscarriages, women with miscarriages had 1.13 (1.03-1.24), 1.16 (1.07-1.25), and 1.20 (1.05-1.38) times the rates of these same outcomes, respectively; these associations were dose dependent, with each additional miscarriage increasing the rates of myocardial and cerebral infarction and renovascular hypertension by 9% (3% to 16%), 13% (7% to 19%), and 19% (9% to 30%), respectively. Associations were strongest in younger women (<35 years). Conclusions-Pregnancy

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pregnancy Loss and Later Risk of Atherosclerotic Disease

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“…Ranthe et al, however, also reported a significant association of pregnancy loss and stroke, which may be due to the greater number of stroke events (4,053 vs 1,503 for WHI) and ascertainment of history of pregnancy loss based on Medical Birth Register data rather than self-reports used in most other studies. 14,28,29 There are several limitations that should be mentioned. Pregnancy loss was based on self-report, and self-reports of miscarriage and stillbirth could be subject to misclassification bias.…”

Section: Discussionmentioning

confidence: 99%

Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women's Health Initiative

Parker

Lü

Sands-Lincoln

et al. 2014

The Annals of Family Medicine

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PURPOSE Metabolic, hormonal, and hemostatic changes associated with pregnancy loss (stillbirth and miscarriage) may contribute to the development of cardiovascular disease (CVD) in adulthood. This study evaluated prospectively the association between a history of pregnancy loss and CVD in a cohort of postmenopausal women.METHODS Postmenopausal women (77,701) were evaluated from 1993-1998. Information on baseline reproductive history, sociodemographic, and CVD risk factors were collected. The associations between 1 or 2 or more miscarriages and 1 or more stillbirths with occurrence of CVD were evaluated using multiple logistic regression.RESULTS Among 77,701 women in the study sample, 23,538 (30.3%) reported a history of miscarriage; 1,670 (2.2%) reported a history of stillbirth; and 1,673 (2.2%) reported a history of both miscarriage and stillbirth. Multivariable-adjusted odds ratio (OR) for coronary heart disease (CHD) for 1 or more stillbirths was 1.27 (95% CI, 1.07-1.51) compared with no stillbirth; for women with a history of 1 miscarriage, the OR = 1.19 (95% CI, 1.08-1.32); and for 2 or more miscarriages the OR = 1.18 (95% CI, 1.04-1.34) compared with no miscarriage. For ischemic stroke, the multivariable odds ratio for stillbirths and miscarriages was not significant. CONCLUSIONSPregnancy loss was associated with CHD but not ischemic stroke. Women with a history of 1 or more stillbirths or 1 or more miscarriages appear to be at increased risk of future CVD and should be considered candidates for closer surveillance and/or early intervention; research is needed into better understanding the pathophysiologic mechanisms behind the increased risk of CVD associated with pregnancy loss.

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“…Observational studies suggest that women with a history of RM also have an increased risk of CVD 6, 7, 8, 9. Several hypotheses are possible for the association between both diseases; shared common risk factors such as obesity and smoking,10 endothelial dysfunction,11 and a genetic predisposition is assumed 12…”

Section: Introductionmentioning

confidence: 99%

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

Wagner

Beshay

Rooijakkers

et al. 2018

Acta Obstet Gynecol Scand

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IntroductionCardiovascular disease is the leading cause of death in women. Observational studies suggest that women with a history of recurrent miscarriage have an increased risk of cardiovascular disease.Material and methodsWomen who visited the recurrent miscarriage clinic at Leiden University Medical Center between 2000 and 2010 and who had their third consecutive miscarriage before the age of 31 years, were invited to participate in this follow‐up study (between 2012 and 2014). The reference group consisted of women with at least one uncomplicated pregnancy and no miscarriage, matched by zip code, age, and date of pregnancy. All women were invited for risk factor screening, including physical examination and blood collection. Main outcome measures were the (extrapolated) 10‐ and 30‐year cardiovascular risk scores using the Framingham risk score. A subanalysis was performed for women with idiopathic recurrent miscarriage.ResultsThirty‐six women were included in both groups. Mean follow up was 7.5 years. Women with recurrent miscarriage had a significantly higher extrapolated 10‐year cardiovascular risk score (mean 6.24%, SD 5.44) compared with women with no miscarriage (mean 3.56%, SD 1.82, P = .007) and a significantly higher 30‐year cardiovascular risk score (mean 9.86%, SD 9.10) compared with women with no miscarriage (mean 6.39%, SD 4.20, P = .04). Similar results were found in women with idiopathic recurrent miscarriage (n = 28).ConclusionsWomen with a history of recurrent miscarriage differ in cardiovascular risk profile at a young age compared with women with no miscarriage. The findings support an opportunity to identify women at risk of cardiovascular disease later in life and a possible moment for intervention.

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Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study

Abstract: The parents of women who experience recurrent miscarriage are more likely to experience IHD. Recurrent miscarriage and IHD may have common patho-physiological pathways and genetic predispositions.

Cited by 47 publications

References 19 publications

Pregnancy Loss and Later Risk of Atherosclerotic Disease

Pregnancy Loss and Later Risk of Atherosclerotic Disease

Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women's Health Initiative

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

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