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Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study

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Abstract:

Please cite this paper as: Smith G, Wood A, Pell J, Hattie J. Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study. BJOG 2011;118:557–563. Objective 

To determine whether women experiencing recurrent miscarriage were more likely to have a family history of cardiovascular disease. Design 

Retrospective cohort study. Setting 

Women having a first birth in Scotland between 1992 and 2006. Sample 

A total of 74 730 first births were linked to the hospital admission and death certification data for the women’s parents through the women’s birth certificates. Methods 

The incidence of cardiovascular disease in the women’s parents was related to the number of miscarriages experienced before their daughters’ first births using a Cox proportional hazards model. Main outcome measures 

Death or hospital admission of the women’s parents for ischaemic heart disease (IHD), cerebrovascular disease (CVD) or venous thromboembolism (VTE). Main results 

There was an increased incidence of IHD in the parents of women who experienced two miscarriages before their first birth (hazard ratio 1.25, 95% CI 1.04–1.49) and parents of women who experienced three or more miscarriages before their first birth (hazard ratio 1.56, 95% CI 1.14–2.15). Adjustment for the characteristics of the women at the time of the first birth was without material effect. There was no significant association between miscarriage and family history of CVD or VTE. There was no significant association between the number of therapeutic terminations of pregnancy before the first birth and the incidence of any type of cardiovascular disease in the women’s parents. Conclusions 

The parents of women who experience recurrent miscarriage are more likely to experience IHD. Recurrent miscarriage and IHD may have common patho-physiological pathways and genetic predispositions.

Keywords: Cerebrovascular disease; epidemiology; family history; ischaemic heart disease; miscarriage; venous thromboembolism

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2010.02890.x

Affiliations: 1:  Department of Obstetrics and Gynaecology and 2:  Department of Public Health and Primary Care, Cambridge University, Cambridge, UK 3:  Public Health Section, University of Glasgow, Glasgow, UK 4:  Information Services Division, NHS National Services Scotland, Edinburgh, UK

Publication date: April 1, 2011

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