• Annals of family medicine · Jul 2014

    Risk of cardiovascular disease among postmenopausal women with prior pregnancy loss: the women's health initiative.

    • Donna R Parker, Bing Lu, Megan Sands-Lincoln, Candyce H Kroenke, Cathy C Lee, Mary O'Sullivan, Hannah L Park, Nisha Parikh, Robert S Schenken, and Charles B Eaton.
    • Departments of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, Rhode Island (Parker, Eaton); Center for Primary Care and Prevention, Memorial Hospital of Rhode Isla... more nd, Pawtucket, Rhode Island (Parker, Eaton); Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts (Lu); University of Pennsylvania Perelman School of Medicine, Center for Sleep and Circadian Neurobiology, Philadelphia, Pennsylvania (Sands-Lincoln); Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Brzyski, Schenken); Kaiser Permanente Division of Research, Oakland, California (Kroenke); Division of Geriatric Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (Lee); University of Miami, Miller School of Medicine, Department of Obstetrics/Gynecology, Miami, Florida (O'Sullivan); UC Irvine School of Medicine, Department of Epidemiology, Irvine, California (Park); John A. Burns School of Medicine (JABSOM), University of Hawaii, Honolulu, Hawaii (Parikh). Donna_Parker@Brown.edu. less
    • Ann Fam Med. 2014 Jul 1; 12 (4): 302-9.

    PurposeMetabolic, hormonal, and hemostatic changes associated with pregnancy loss (stillbirth and miscarriage) may contribute to the development of cardiovascular disease (CVD) in adulthood. This study evaluated prospectively the association between a history of pregnancy loss and CVD in a cohort of postmenopausal women.MethodsPostmenopausal women (77,701) were evaluated from 1993-1998. Information on baseline reproductive history, sociodemographic, and CVD risk factors were collected. The associations between 1 or 2 or more miscarriages and 1 or more stillbirths with occurrence of CVD were evaluated using multiple logistic regression.ResultsAmong 77,701 women in the study sample, 23,538 (30.3%) reported a history of miscarriage; 1,670 (2.2%) reported a history of stillbirth; and 1,673 (2.2%) reported a history of both miscarriage and stillbirth. Multivariable-adjusted odds ratio (OR) for coronary heart disease (CHD) for 1 or more stillbirths was 1.27 (95% CI, 1.07-1.51) compared with no stillbirth; for women with a history of 1 miscarriage, the OR=1.19 (95% CI, 1.08-1.32); and for 2 or more miscarriages the OR=1.18 (95% CI, 1.04-1.34) compared with no miscarriage. For ischemic stroke, the multivariable odds ratio for stillbirths and miscarriages was not significant.ConclusionsPregnancy loss was associated with CHD but not ischemic stroke. Women with a history of 1 or more stillbirths or 1 or more miscarriages appear to be at increased risk of future CVD and should be considered candidates for closer surveillance and/or early intervention; research is needed into better understanding the pathophysiologic mechanisms behind the increased risk of CVD associated with pregnancy loss.© 2014 Annals of Family Medicine, Inc.

      Pubmed     Free full text   Copy Citation  

      Add institutional full text...

    Notes

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.