title: Pregnancy loss and risk of ischaemic stroke and myocardial infarction.
abstract: We investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18-50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one pregnancy were compared for pregnancy loss in a control group. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for matching variables, cardiovascular risk factors, cardiovascular family history and the presence of antiphospholipid antibodies, were calculated for the number of pregnancy losses as well as the type of unsuccessful pregnancy (early miscarriage, late miscarriage and stillbirth). 165 IS cases, 218 MI cases and 743 controls were included. Women with multiple (≥3) pregnancy loss had a doubled risk of arterial thrombosis (OR 2·37, 95%CI 0·99-5·70) compared with women without pregnancy loss, similarly to women who experienced stillbirth (OR 1·68, 95%CI 0·79-3·55). Both relative risks were higher for IS (OR 3·51, 95%CI 1·08-11·35 and 2·06, 95%CI 0·81-5·23, respectively) than for MI (OR 2·04, 95%CI 0·71-5·86 and 1·04, 95%CI 0·39-2·79). Adjustment for antiphospholipid antibodies did not affect the estimates. Multiple pregnancy loss and stillbirth increases the risk of IS and, to a lesser extent, of MI, even when other cardiovascular risk factors and antiphospholipid antibodies are accounted for.
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden , The Netherlands.|A. Bianchi Bonomi Haemophilia and Thrombosis Centre, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Maino
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden , The Netherlands.|Centre for Stroke research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Bob
authors.initials: B
authors.lastname: Siegerink
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden , The Netherlands.|Brain Centre Rudolph Magnus, dept Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, the Netherlands.|Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
authors.affiliation: A. Bianchi Bonomi Haemophilia and Thrombosis Centre, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Martinelli
authors.affiliation: A. Bianchi Bonomi Haemophilia and Thrombosis Centre, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Flora
authors.initials: F
authors.lastname: Peyvandi
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden , The Netherlands.|Department of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, the Netherlands.
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
mesh_terms: D000026:Abortion, Habitual; D000022:Abortion, Spontaneous; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D050497:Stillbirth; D020521:Stroke / Q000209:etiology*; D055815:Young Adult
keywords: antiphospholipid antibodies; arterial thrombosis; pregnancy; stroke; thrombophilia