Dose dependent association between number of consecutive miscarriages and cardiovascular disease later in life

evidence from a Scottish cohort

Marise M Wagner, Sohinee Bhattacharya, Jantien Visser, Philip C Hannaford, Kitty W M Bloemenkamp

Research output: Contribution to journalAbstract

Abstract

INTRODUCTION: Globally, cardiovascular disease is the major cause of death in women. This research was performed to assess if consecutive miscarriage is an independent risk factor for developing cardiovascular disease.

METHODS: Women with at least one miscarriage or live birth recorded from 1950 - 2010 in the Aberdeen Maternity and Neonatal Databank were included in this cohort study. The exposed groups consisted of women with 1, 2 or ≥ 3 consecutive miscarriages; the unexposed group consisted of all women with at least one live birth and no miscarriages. Women were linked to Scottish Morbidity Records for hospital admissions for cardiovascular conditions, cardiac surgery and death registrations. Primary outcomes were ischemic heart disease, cerebrovascular disease and a composite outcome of any disease of the circulatory system. Event-free survival analyses were done using Cox regression.

RESULTS: After excluding women with pre-existing hypertension, type 1 diabetes mellitus, kidney disease and ‘disease of circulatory system’, 60105 women were analysed; 9419 with one, 940 with two, 167 with ≥ three miscarriages and 49579 with no miscarriage. A dose-dependent relationship with increasing number of consecutive miscarriages was found in the univariate analyses. In the multivariate analyses (adjusted for maternal age, body mass index, social class and smoking) the association remained for ischemic heart disease - 1 miscarriage: Hazard Ratios (HR) were 1.28 (95% confidence interval (CI) 0.96-1.72), 2 miscarriages: HR 2.40 (95%CI 1.28-4.51) and ≥ 3 miscarriages: HR 3.80 (95%CI 0.94-15.33); and any disease of the circulatory system- HR 1.19 (95%CI 1.08-1.31), HR 1.29 (95%CI 1.00-1.66) and HR 1.32 (95%CI 0.73- 2.40), respectively. Similar results were obtained using non-consecutive miscarriages in a sensitivity analysis.

CONCLUSIONS: Women with a history of consecutive miscarriage appear to have an increased risk of ischemic heart disease and possibly other cardiovascular outcomes later in life.
Original languageEnglish
Article numberO-021
Pages (from-to)63A
Number of pages1
JournalReproductive Sciences
Volume22
Issue number1 Suppl.
DOIs
Publication statusPublished - Mar 2015

Keywords

  • Miscarriages
  • cardiovascular disease

Cite this

Dose dependent association between number of consecutive miscarriages and cardiovascular disease later in life : evidence from a Scottish cohort. / Wagner, Marise M; Bhattacharya, Sohinee; Visser, Jantien; Hannaford, Philip C; Bloemenkamp, Kitty W M.

In: Reproductive Sciences, Vol. 22, No. 1 Suppl., O-021, 03.2015, p. 63A.

Research output: Contribution to journalAbstract

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title = "Dose dependent association between number of consecutive miscarriages and cardiovascular disease later in life: evidence from a Scottish cohort",
abstract = "INTRODUCTION: Globally, cardiovascular disease is the major cause of death in women. This research was performed to assess if consecutive miscarriage is an independent risk factor for developing cardiovascular disease. METHODS: Women with at least one miscarriage or live birth recorded from 1950 - 2010 in the Aberdeen Maternity and Neonatal Databank were included in this cohort study. The exposed groups consisted of women with 1, 2 or ≥ 3 consecutive miscarriages; the unexposed group consisted of all women with at least one live birth and no miscarriages. Women were linked to Scottish Morbidity Records for hospital admissions for cardiovascular conditions, cardiac surgery and death registrations. Primary outcomes were ischemic heart disease, cerebrovascular disease and a composite outcome of any disease of the circulatory system. Event-free survival analyses were done using Cox regression. RESULTS: After excluding women with pre-existing hypertension, type 1 diabetes mellitus, kidney disease and ‘disease of circulatory system’, 60105 women were analysed; 9419 with one, 940 with two, 167 with ≥ three miscarriages and 49579 with no miscarriage. A dose-dependent relationship with increasing number of consecutive miscarriages was found in the univariate analyses. In the multivariate analyses (adjusted for maternal age, body mass index, social class and smoking) the association remained for ischemic heart disease - 1 miscarriage: Hazard Ratios (HR) were 1.28 (95{\%} confidence interval (CI) 0.96-1.72), 2 miscarriages: HR 2.40 (95{\%}CI 1.28-4.51) and ≥ 3 miscarriages: HR 3.80 (95{\%}CI 0.94-15.33); and any disease of the circulatory system- HR 1.19 (95{\%}CI 1.08-1.31), HR 1.29 (95{\%}CI 1.00-1.66) and HR 1.32 (95{\%}CI 0.73- 2.40), respectively. Similar results were obtained using non-consecutive miscarriages in a sensitivity analysis. CONCLUSIONS: Women with a history of consecutive miscarriage appear to have an increased risk of ischemic heart disease and possibly other cardiovascular outcomes later in life.",
keywords = "Miscarriages, cardiovascular disease",
author = "Wagner, {Marise M} and Sohinee Bhattacharya and Jantien Visser and Hannaford, {Philip C} and Bloemenkamp, {Kitty W M}",
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doi = "10.1177/1933719115579631",
language = "English",
volume = "22",
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journal = "Reproductive Sciences",
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TY - JOUR

T1 - Dose dependent association between number of consecutive miscarriages and cardiovascular disease later in life

T2 - evidence from a Scottish cohort

AU - Wagner, Marise M

AU - Bhattacharya, Sohinee

AU - Visser, Jantien

AU - Hannaford, Philip C

AU - Bloemenkamp, Kitty W M

PY - 2015/3

Y1 - 2015/3

N2 - INTRODUCTION: Globally, cardiovascular disease is the major cause of death in women. This research was performed to assess if consecutive miscarriage is an independent risk factor for developing cardiovascular disease. METHODS: Women with at least one miscarriage or live birth recorded from 1950 - 2010 in the Aberdeen Maternity and Neonatal Databank were included in this cohort study. The exposed groups consisted of women with 1, 2 or ≥ 3 consecutive miscarriages; the unexposed group consisted of all women with at least one live birth and no miscarriages. Women were linked to Scottish Morbidity Records for hospital admissions for cardiovascular conditions, cardiac surgery and death registrations. Primary outcomes were ischemic heart disease, cerebrovascular disease and a composite outcome of any disease of the circulatory system. Event-free survival analyses were done using Cox regression. RESULTS: After excluding women with pre-existing hypertension, type 1 diabetes mellitus, kidney disease and ‘disease of circulatory system’, 60105 women were analysed; 9419 with one, 940 with two, 167 with ≥ three miscarriages and 49579 with no miscarriage. A dose-dependent relationship with increasing number of consecutive miscarriages was found in the univariate analyses. In the multivariate analyses (adjusted for maternal age, body mass index, social class and smoking) the association remained for ischemic heart disease - 1 miscarriage: Hazard Ratios (HR) were 1.28 (95% confidence interval (CI) 0.96-1.72), 2 miscarriages: HR 2.40 (95%CI 1.28-4.51) and ≥ 3 miscarriages: HR 3.80 (95%CI 0.94-15.33); and any disease of the circulatory system- HR 1.19 (95%CI 1.08-1.31), HR 1.29 (95%CI 1.00-1.66) and HR 1.32 (95%CI 0.73- 2.40), respectively. Similar results were obtained using non-consecutive miscarriages in a sensitivity analysis. CONCLUSIONS: Women with a history of consecutive miscarriage appear to have an increased risk of ischemic heart disease and possibly other cardiovascular outcomes later in life.

AB - INTRODUCTION: Globally, cardiovascular disease is the major cause of death in women. This research was performed to assess if consecutive miscarriage is an independent risk factor for developing cardiovascular disease. METHODS: Women with at least one miscarriage or live birth recorded from 1950 - 2010 in the Aberdeen Maternity and Neonatal Databank were included in this cohort study. The exposed groups consisted of women with 1, 2 or ≥ 3 consecutive miscarriages; the unexposed group consisted of all women with at least one live birth and no miscarriages. Women were linked to Scottish Morbidity Records for hospital admissions for cardiovascular conditions, cardiac surgery and death registrations. Primary outcomes were ischemic heart disease, cerebrovascular disease and a composite outcome of any disease of the circulatory system. Event-free survival analyses were done using Cox regression. RESULTS: After excluding women with pre-existing hypertension, type 1 diabetes mellitus, kidney disease and ‘disease of circulatory system’, 60105 women were analysed; 9419 with one, 940 with two, 167 with ≥ three miscarriages and 49579 with no miscarriage. A dose-dependent relationship with increasing number of consecutive miscarriages was found in the univariate analyses. In the multivariate analyses (adjusted for maternal age, body mass index, social class and smoking) the association remained for ischemic heart disease - 1 miscarriage: Hazard Ratios (HR) were 1.28 (95% confidence interval (CI) 0.96-1.72), 2 miscarriages: HR 2.40 (95%CI 1.28-4.51) and ≥ 3 miscarriages: HR 3.80 (95%CI 0.94-15.33); and any disease of the circulatory system- HR 1.19 (95%CI 1.08-1.31), HR 1.29 (95%CI 1.00-1.66) and HR 1.32 (95%CI 0.73- 2.40), respectively. Similar results were obtained using non-consecutive miscarriages in a sensitivity analysis. CONCLUSIONS: Women with a history of consecutive miscarriage appear to have an increased risk of ischemic heart disease and possibly other cardiovascular outcomes later in life.

KW - Miscarriages

KW - cardiovascular disease

U2 - 10.1177/1933719115579631

DO - 10.1177/1933719115579631

M3 - Abstract

VL - 22

SP - 63A

JO - Reproductive Sciences

JF - Reproductive Sciences

SN - 1933-7191

IS - 1 Suppl.

M1 - O-021

ER -