Does pregnancy loss mean future CVD risk?

Women who have a history of pregnancy loss, either miscarriage or stillbirth, may be at greater risk of postmenopausal cardiovascular disease (CVD), according to a recent study in The Annals of Family Medicine.

Led by researchers at Brown University, the analysis was based on data from the Women’s Health Initiative cohort of 77,701 women who were evaluated from 1993 to 1998. Information on baseline reproductive history, sociodemographic, and CVD risk factors was collected. Multiple logistic regression was used to evaluate the association between 1 or 2 or more miscarriages and 1 or more stillbirths with occurrences of CVD.

In the study sample, 23,538 women (30.3%) reported a history of miscarriage; 1670 (2.2%) reported a stillbirth, and 1673 women reported a history of stillbirth and miscarriage. When compared with no stillbirth history, women with 1 or more stillbirths had an adjusted odds ratio (aOR) of 1.27 (95% confidence interval [CI], 1.07-1.51) for coronary heart disease (CHD). For women with a history of 1 miscarriage, the aOR was 1.19 (95% CI 1.08-1.32) for CHD; in women with 2 or more miscarriages the aOR was 1.18 (95% CI, 1.04-1.34). The multivariable odds ratio for ischemic stroke and stillbirths and miscarriages was not considered significant.

The researchers concluded that pregnancy loss was associated with CHD but not with ischemic stroke. Women with a history of pregnancy loss should be considered for close cardiovascular surveillance and potentially early invention. The researchers believe that further research is needed to understand the mechanisms behind theincreased risk of CVD associated with pregnancy loss.

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