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Miscarriage, Stillbirth, and Mortality Risk from Stroke in Women: Findings from the PLCO Study

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Specialty Public Health
Date 2024 Dec 5
PMID 39638289
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Abstract

Objectives: Existing evidence suggests that miscarriage and stillbirth are associated with an increased risk of stroke in women. However, the impact of these events on stroke mortality remains unclear. This study aimed to elucidate the potential association between miscarriage and stillbirth and stroke mortality in women.

Methods: We employed a competing risk model using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial to assess the relationship between miscarriage/stillbirth and stroke death. Death from other causes was considered as a competing risk, and we conducted a subgroup analysis to explore the potential impact.

Results: Our study included 68,629 women for miscarriage and 65,343 women for stillbirth. No significant association was observed between miscarriage and stroke mortality (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.84 to 1.10; p=0.58). While a single stillbirth did not show a significant association (HR, 0.81; 95% CI, 0.57 to 1.15; p=0.23), recurrent stillbirth (≥2) was associated with a significantly increased risk of stroke mortality compared to women with no stillbirths (HR, 2.24; 95% CI, 1.45 to 3.46; p<0.001).

Conclusions: Our findings suggest that recurrent stillbirth, but not single events, is associated with an elevated risk of stroke mortality in women. Further research is warranted to clarify the underlying mechanisms and potential long-term health implications of recurrent pregnancy loss.

References
1.
Calderon-Margalit R, Friedlander Y, Yanetz R, Deutsch L, Manor O, Harlap S . Late stillbirths and long-term mortality of mothers. Obstet Gynecol. 2007; 109(6):1301-8. DOI: 10.1097/01.AOG.0000264548.10767.ea. View

2.
Liang C, Chung H, Dobson A, Hayashi K, van der Schouw Y, Kuh D . Infertility, recurrent pregnancy loss, and risk of stroke: pooled analysis of individual patient data of 618 851 women. BMJ. 2022; 377:e070603. PMC: 9214882. DOI: 10.1136/bmj-2022-070603. View

3.
Bungum A, Glazer C, Arendt L, Schmidt L, Pinborg A, Bonde J . Risk of hospitalization for early onset of cardiovascular disease among infertile women: a register-based cohort study. Hum Reprod. 2019; 34(11):2274-2281. DOI: 10.1093/humrep/dez154. View

4.
Parker D, Lu B, Sands-Lincoln M, Kroenke C, Lee C, OSullivan M . Risk of cardiovascular disease among postmenopausal women with prior pregnancy loss: the women's health initiative. Ann Fam Med. 2014; 12(4):302-9. PMC: 4096466. DOI: 10.1370/afm.1668. View

5.
Peters S, Woodward M . Women's reproductive factors and incident cardiovascular disease in the UK Biobank. Heart. 2018; 104(13):1069-1075. DOI: 10.1136/heartjnl-2017-312289. View