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Postmenopausal women with prior pregnancy loss may be at risk for CHD
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Women with a prior loss of pregnancy had a higher risk for CHD later in life than women with no history of stillbirth or miscarriage, according to new data from the Women’s Health Initiative.
“These findings contribute to the growing body of evidence that the metabolic, hormonal and hemostatic pathway alterations that are associated with a pregnancy loss may contribute to the development of [CHD] in adulthood,” Donna R. Parker, ScD, director of community health and research at the Center for Primary Care and Prevention at Memorial Hospital of Rhode Island, Pawtucket, R.I., said in a press release.
The study focused on 77,701 postmenopausal women in the Women’s Health Initiative study who were evaluated from 1993 to 1998. Parker and colleagues studied data on baseline reproductive history, sociodemographics and CVD risk factors to evaluate the association between pregnancy loss, defined as stillbirth or miscarriage, and the occurrence of CVD.
In total, 30.3% of the women reported a history of miscarriage, 2.2% reported a history of stillbirth, and 2.2% reported a history of both miscarriage and stillbirth.
Compared with women who no history of stillbirth, one or more stillbirths was associated with a higher likelihood of developing CHD (OR=1.27; 95% CI, 1.07-1.51). Compared with women with no history of miscarriage, one miscarriage (OR=1.19; 95% CI, 1.08-1.32) and more than one miscarriage (OR=1.18; 95% CI, 1.04-1.34) was associated with a higher likelihood of developing CHD.
The researchers reported no association between pregnancy loss and risk for ischemic stroke (≥1 stillbirth, OR=1.13; 95% CI, 0.89-1.43; 1 miscarriage, OR=1.05; 95% CI, 0.91-1.19; ≥2 miscarriages, OR=0.93; 95% CI, 0.77-1.13).
“Given that 15% of CVD events in women occur in the absence of conventional risk factors, reproductive history of pregnancy loss may be a potentially clinically useful predictive marker of CVD risk,” Parker and colleagues wrote. “Our findings, although not conclusive, suggest that women with a history of miscarriage or a single stillbirth may be at increased CVD risk and should be considered candidates for closer surveillance and/or early intervention by their primary care physician so that risk factors can be carefully monitored and controlled.”
Disclosure: The study was funded by the NHLBI. The researchers report no relevant financial disclosures.
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