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Pregnancy Loss and Later Risk of Atherosclerotic Disease
Abstract
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.
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“A large (1 031 279 participants) Danish cohort study103 noted that women who had a miscarriage were at a higher risk of stroke (incidence rate ratio 1.16, 95% confidence interval 1.07 to 1.25).”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [103]
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Citations
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(2013) · Circulation · doi:10.1161/01.cir.0000436732.32318.7e
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Metadata
- Authors
- Ranthe, M. F., Andersen, E. A. W., Wohlfahrt, J., Bundgaard, H., Melbye, M., & Boyd, H. A.
- Affiliations
- Statens Serum Institut (DK)
- Venue
- Circulation
- Published
- 2013-04-30
- Volume
- 127
- Issue
- 17
- Pages
- 1775-1782
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2050100676
- Cited by
- 117
- References
- 25
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 14 · 2023: 7 · 2022: 12 · 2021: 10 · 2020: 12 · 2019: 19 · 2018: 5 · 2017: 7 · 2016: 5 · 2015: 5 · 2014: 3 · 2013: 4
- FWCI
- 6.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Funders
- Hjerteforeningen
- A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Keywords
- miscarriage, stillbirth, atherosclerosis, myocardial infarction, cerebral infarction, renovascular hypertension, cardiovascular risk, women's health, shared etiology
- MeSH terms
- Abortion, Spontaneous, Adolescent, Adult, Child, Female, Follow-Up Studies, Humans, Middle Aged, Pregnancy, Pregnancy Complications, Risk Factors, Time Factors, Cohort Studies, Atherosclerosis, Stillbirth, Live Birth, Young Adult
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