Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study.
OBJECTIVE
To determine whether women experiencing recurrent miscarriage were more likely to have a family history of cardiovascular disease.


METHODS
Retrospective cohort study.


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


METHODS
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.


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


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.
Department of Obstetrics and Gynaecology, Cambridge University, Rosie Maternity Hospital, Cambridge, UK. gcss2@cam.ac.uk
G C S
GC
Smith
A M
AM
Wood
J P
JP
Pell
J
J
Hattie
D000026:Abortion, Habitual / Q000235:genetics*; D000032:Abortion, Therapeutic / Q000706:statistics & numerical data; D000328:Adult; D002561:Cerebrovascular Disorders / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D017202:Myocardial Ischemia / Q000235:genetics*; D010375:Pedigree; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000235:genetics*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D054556:Venous Thromboembolism / Q000235:genetics; D055815:Young Adult