Women at higher risk of stroke after miscarriage or death

(Gita Mishra, Chen Liang and Jenny Doust, University of Queensland

Queensland, June 23 (The Conversation) Women who have had a miscarriage or a fatality have a higher risk of stroke with each miscarriage or death, according to new research. Stroke is a condition in which blood cannot reach the brain due to a blockage or rupture of an artery.

Trying to establish this link is difficult because it requires studying a large number of women over a long period of time and having reliable data on women’s experiences. Our study, published today in the British Medical Journal, is the first to conclusively show the link between pregnancy loss and stroke.

Many women are unaware that their experiences during pregnancy can be an early sign of later health hazards. Our findings suggest that your doctors should be alert to your highest risk.

It is possible that infertility, miscarriage, and stillbirth, among other health problems, may increase the risk of stroke. These can include endocrine disorders (low resistance to estrogen or insulin), inflammation, problems with endothelial cells that help blood flow, psychiatric disorders, unhealthy behaviors (such as smoking) or obesity.

Lack of love and risk of stroke

Our research is based on data collected from 618,851 women who participated in eight separate studies in Australia, China, Japan, the Netherlands, Sweden, the United Kingdom, and the United States.

The women were between 32 and 73 years old when they first enrolled in the study and were studied for an average of 11 years.

The study showed that at the time of the study, 9,265 women (2.8%) had at least one non-fatal stroke and 4,003 women (0.7%) had one fatal stroke. In total, 91,569 (16.2%) women have a history of miscarriage, while 24,873 (4.6%) have a history of stillbirth.

Among women who had ever become pregnant, women who reported a miscarriage had an 11% higher risk of non-fatal stroke and a 17% higher risk of fatal stroke, compared with women. women who did not have a miscarriage.

The risk increased with each miscarriage, women with three or more miscarriages had a 35% higher risk of non-fatal stroke (from an incidence rate of 58 per 100,000 “person years”) and an 82% higher risk of these fatal strokes (11.3 per 100,000 years to 18 per 100,000) compared to women who had never had an abortion.

Birth death also significantly increased the risk of stroke.

Among women who had ever been pregnant, women who had a history of stillbirth had a 31% higher risk of non-fatal stroke (from a rate of 42 per 100,000 people years to 69.5 per 100,000) and of suffering a fatal stroke had 7%. higher risk.

Similarly, the greater the number of deaths, the greater the risk of subsequent stroke; women who had two or more deaths were 26% more likely to suffer a fatal stroke (11 per 100,000 people).

This is the first study to show an association with stroke subtypes: death was associated with a non-fatal ischemic stroke (blockage) or a fatal hemorrhagic (hemorrhagic) stroke, while miscarriage was associated with the two subtypes of stroke.

Our study reinforces the results of a previous systematic review that found similar results but showed limited evidence associated with stroke subtypes.

Among the possible explanations for these relationships, problems with endothelial cells (which control relaxation and vascular contraction, as well as release blood-clotting enzymes) can lead to pregnancy loss due to problems with the placenta. These problems are also related to how blood vessels dilate and swell or block during a stroke.

adjustment with known risk factors

Our findings were adjusted for several known risk factors for stroke: body mass index, whether women smoked, had high blood pressure, or diabetes. The figures were also adjusted for ethnicity and educational level.

By adjusting to risk factors, we can isolate the potential risk associated with the number of miscarriages or miscarriages that women have.

What should women and their doctors do with this information? When doctors do a heart health check, they look at the risk of heart disease as a whole, that is, heart disease, heart failure, and stroke. Given these risks, doctors assess and predict the risk of future illness.

Current Australian guidelines recommend that Torres Strait Islander aborigines and islanders should have regular heart health check-ups for people aged 45 to 74 or over the age of 30: this is when heart disease. The danger begins to increase.

The guidelines recommend medications (medications for blood pressure and / or medications to lower lipids, such as statins) when the risk of heart disease exceeds 15% for the next five years.

These guidelines are currently being updated by the Alliance for the Prevention of Chronic Disease in Australia (which includes the Cancer Council Australia, Diabetes Australia, Kidney Health Australia, the National Heart Foundation of Australia and the Stroke Foundation), but the recent international guidelines on medicine are low-level. . recommend.


Regardless of the risk of heart disease, the best way to avoid a stroke is to adopt as much healthy lifestyle as possible: quit smoking, follow a vegetarian diet, don’t drink too much alcohol, and exercise regularly.

These lifestyles reduce the risk of heart disease for everyone, but doctors will have to work especially hard to help those at long-term risk.

Our research shows that miscarriages and stillbirths are signs that a woman is at increased risk for heart disease. When a woman develops other risk factors, such as high blood pressure, diabetes, or high cholesterol, she may develop heart disease.

Women who have had a miscarriage or stillbirth should talk to their doctor. Knowing that you are at a higher risk of having a stroke, it is important to monitor your health and make lifestyle changes.

The physician should ask about women’s reproductive history and be aware of recurrent miscarriage and stillbirth as possible predictors of stroke risk.

The conversation Ekta


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