History of stillbirth was associated with an increased rate of myocardial infarction (IRR 2.69; 95% CI 2.06-3.50) compared to no stillbirth, with risks also elevated for miscarriage.
Cohort (n=1,031,279)
Does a history of miscarriage or stillbirth increase the later risk of myocardial infarction, cerebral infarction, and renovascular hypertension in women?
Pregnancy losses, including miscarriages and stillbirths, are associated with a significantly increased subsequent risk of atherosclerotic diseases such as myocardial infarction and cerebral infarction.
Relative Risk: 2.69 (95% CI 2.06–3.5)
BACKGROUND: 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 losses were associated with subsequent risks of myocardial infarction, cerebral infarction, and renovascular hypertension, consistent with either shared etiology or the initiation of pathological processes by a pregnancy loss leading to atherosclerosis.
Ranthe et al. (Thu,) conducted a cohort in Pregnancy loss (miscarriage and stillbirth) (n=1,031,279). Stillbirth or miscarriage vs. No stillbirth or no miscarriage was evaluated on Myocardial infarction (stillbirth vs no stillbirth) (IRR 2.69, 95% CI 2.06-3.50). History of stillbirth was associated with an increased rate of myocardial infarction (IRR 2.69; 95% CI 2.06-3.50) compared to no stillbirth, with risks also elevated for miscarriage.