Health: Women who miscarry have a higher risk of stroke

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Infertility and pregnancy loss are linked to a slightly increased risk of stroke, a study shows.

The study looked at 620,000 women in seven countries and found that recurrent miscarriages are the biggest increase in stroke risk.

Many other factors could explain the relatively weak association, a gynecologist said.

Women who have had infertility, a miscarriage or a stillbirth may have a slightly increased risk of stroke, a study published Wednesday in the journal BMJ shows. The report, which analyzed data from eight studies from seven countries, suggests that women who have experienced infertility or pregnancy loss should be counseled on how to reduce their risk of stroke, the authors said.

Women are generally at a higher risk of suffering and dying from a stroke than men. According to the American Heart Association, stroke is the number three cause of death in women. And while certain factors like high blood pressure and diabetes increase risk, they don’t explain why women are more susceptible. Previous research on adverse pregnancy outcomes and stroke was inconclusive, so the authors of the current study wanted to get to the bottom of the matter. For the analysis, they examined a database that recorded the health and chronic diseases of women from Australia, China, Japan, the Netherlands, Sweden, the United Kingdom and the United States. A total of around 620,000 women between the ages of 30 and 70 were taken into account.

The study found that women who had experienced multiple stillbirths had the highest risk of fatal stroke

Using questionnaires and hospital records, the researchers found that women with a history of infertility had a 14 percent higher risk of nonfatal stroke than women without infertility. Women who had a miscarriage had an 11 percent higher risk than women without a miscarriage, and women who had a stillbirth had a risk over 30 percent higher than women without a stillbirth.

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The study found that the more miscarriages, the higher the risk. And when it came to fatal strokes, women with multiple stillbirths were most at risk. Still, from the available data, only 2.8 percent of the participants suffered a non-fatal stroke and 0.7 percent a fatal stroke.

Other medical conditions or lifestyle factors may explain the results

According to the researchers, the link between infertility and stroke risk could be explained by other conditions, such as polycystic ovary syndrome (PCOS), which can both impair fertility and increase the risk of stroke. Many miscarriages can indicate a blood vessel problem that both affects the placenta and increases the risk of heart problems, other researchers suggest.

However, a gynecologist who was not involved in the study says the results should be interpreted with caution because the study design has significant flaws. “It’s important for women to understand that there are many different causes that can lead to infertility, repeated pregnancy loss and stillbirth,” said Dr. Patrick Ramsey of University Hospital San Antonio, Texas. “Similarly, there are multiple pathways that increase a patient’s risk of developing a stroke.” Because research hasn’t been able to separate these causes, “it’s almost impossible to apply the findings from this study to a specific patient,” he added .

The authors of the current study also pointed out that lifestyle factors such as smoking may also contribute to poor pregnancy outcomes and stroke. Ramsey said social health determinants (such as income, education and access to health care) as well as environmental factors may also play a role in outcomes.

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However, it’s impossible to know what’s going on based on this investigation alone, Ramsey said. Because the population studied was so large, “even minute differences can become statistically significant” without really meaning much for patient care. He said more detailed studies tracking groups of patients over time are needed. “If we can learn more about a well-defined association between pregnancy outcomes and long-term risk of stroke, we can better help women,” he said.

This text was translated from English by Lisa Ramos-Doce. You can find the original here.

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