Miscarriage and stillbirth in relation to risk of cardiovascular diseases: A systematic review and meta-analysis

Mengmeng Wang; Jinli Zhang; Lijun Yuan; Huifang Hu; Tianze Li; Yifei Feng; Yang Zhao; Yuying Wu; Xueru Fu; Yamin Ke; Yajuan Gao; Yaobing Chen; Weifeng Huo; Longkang Wang; Wenkai Zhang; Xi Li; Jiong Liu; Zelin Huang; Fulan Hu; Ming Zhang; Liang Sun; Dongsheng Hu; Yang Zhao

doi:10.1016/j.ejogrb.2024.03.035

Miscarriage and stillbirth in relation to risk of cardiovascular diseases: A systematic review and meta-analysis

Eur J Obstet Gynecol Reprod Biol. 2024 Mar 27:297:1-7. doi: 10.1016/j.ejogrb.2024.03.035. Online ahead of print.

Authors

Mengmeng Wang¹, Jinli Zhang¹, Lijun Yuan¹, Huifang Hu¹, Tianze Li¹, Yifei Feng¹, Yang Zhao¹, Yuying Wu¹, Xueru Fu¹, Yamin Ke¹, Yajuan Gao¹, Yaobing Chen¹, Weifeng Huo¹, Longkang Wang¹, Wenkai Zhang¹, Xi Li¹, Jiong Liu², Zelin Huang², Fulan Hu³, Ming Zhang³, Liang Sun⁴, Dongsheng Hu⁵, Yang Zhao⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
² Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
³ Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
⁴ Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China.
⁵ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China. Electronic address: dongshenghu563@126.com.
⁶ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China. Electronic address: yzhao20@zzu.edu.cn.

PMID: 38554480
DOI: 10.1016/j.ejogrb.2024.03.035

Abstract

Introduction: The relationship between pregnancy loss and the risk of cardiovascular diseases (CVDs) remains a matter of debate. Our intention in conducting this meta-analysis was to analyze the relationship between miscarriage and stillbirth and risk of CVDs.

Methods: PubMed, Embase, and Web of Science were systematically searched up to May 30, 2023 for all relevant studies. The random-effects model was applied to estimate the pooled relative risks (RRs) and 95% confidence intervals (95% CIs). We evaluated RR estimates for the risk of CVDs with each additional miscarriage and stillbirth through generalized least squares regression.

Results: Twenty-three articles were incorporated into the meta-analysis. For women with a history of miscarriage, the pooled RRs for the risk of total CVDs, coronary heart disease (CHD), stroke, and total CVD deaths were 1.16 (95 % CI 1.10-1.22), 1.26 (1.12-1.41), 1.13 (1.03-1.24), and 1.20 (1.01-1.42), respectively. For women with a history of stillbirth, the pooled RRs for the risk of total CVDs, CHD, stroke, and total CVD deaths were 1.60 (1.34-1.89), 1.30 (1.12-1.50), 1.37 (1.06-1.78), and 1.95 (1.05-3.63), respectively. With each additional miscarriage, the risk increased for total CVDs (1.08, 1.04-1.13), CHD (1.08, 1.04-1.13), and stroke (1.05, 1.00-1.10). With each additional stillbirth, the risk increased for total CVDs (1.11, 1.03-1.21) and CHD (1.13, 1.07-1.19).

Conclusion: This meta-analysis indicates that both miscarriages and stillbirths are related to a higher risk of total CVDs, CHD, stroke, and total CVD deaths. The risk of total CVDs and CHD increased with the number of miscarriages or stillbirths.

Keywords: Cardiovascular diseases; Cohort study; Meta-analysis; Miscarriage; Stillbirth.

Publication types

Review