December 3, 2010
By Patricia Nicholson
Women with a history of miscarriage or stillbirth may be at greater risk of developing cardiovascular disease later in life, compared to women who have never had a miscarriage.
German researchers used data on a group of 11,518 women in Heidelberg ages 35 to 66, all of whom had been pregnant at least once. One-quarter of the women (2,786) had a history of at least one miscarriage, and 69 women had had more than three miscarriages. Two per cent (209) of the women had a history of stillbirth.
In almost 11 years of followup, there were 82 heart attacks in the group. Stillbirth and recurrent miscarriage appeared to be significant risk factors, regardless of age, body mass index (BMI), smoking, fitness and other known cardiovascular risks.
Each incidence of stillbirth was associated with a more than doubled risk of heart attack, compared to women with no history of stillbirth.
The 69 women who had recurrent miscarriages had five times the heart attack risk of women with no miscarriages.
While the reasons for the connection between miscarriage, stillbirth and heart attack risk are not clear, the study authors noted that many underlying health factors may affect both pregnancy and cardiovascular health. Some possible mechanisms include:
- inflammatory reactions caused by certain antibodies, proteins and infections have been linked to both miscarriage and cardiovascular disease
- a high blood level of homocysteine, an amino acid linked to cardiac risks, is also a risk factor for miscarriage and preeclampsia (a serious pregnancy complication involving extremely high blood pressure)
- endothelium (the layer of cells that lines blood vessels) that isn’t functioning properly is an important precursor to atherosclerosis (blocked arteries) and other heart risks, but may also be associated with pregnancy complications
The study results suggest that stillbirth and recurrent miscarriage may be a serious risk factor for heart attack later in life. Women with a history of pregnancy loss may benefit from closer monitoring for cardiovascular disease, as well as preventive strategies.
The study was published in the journal Heart
on Dec. 1, 2010.
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