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The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis

AIMS: Miscarriage and stillbirth have been included in cardiovascular disease (CVD) risk guidelines, however heterogeneity in exposures and outcomes and the absence of reviews assessing induced abortion, prevented comprehensive assessment. We aimed to perform a systematic review and meta-analysis of...

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Autores principales: Kyriacou, Harry, Al-Mohammad, Abdulrahman, Muehlschlegel, Charlotte, Foster-Davies, Lowri, Bruco, Maria Eduarda Ferreira, Legard, Chloe, Fisher, Grace, Simmons-Jones, Fiona, Oliver-Williams, Clare
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617475/
https://www.ncbi.nlm.nih.gov/pubmed/36330356
http://dx.doi.org/10.1093/ehjopen/oeac065
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author Kyriacou, Harry
Al-Mohammad, Abdulrahman
Muehlschlegel, Charlotte
Foster-Davies, Lowri
Bruco, Maria Eduarda Ferreira
Legard, Chloe
Fisher, Grace
Simmons-Jones, Fiona
Oliver-Williams, Clare
author_facet Kyriacou, Harry
Al-Mohammad, Abdulrahman
Muehlschlegel, Charlotte
Foster-Davies, Lowri
Bruco, Maria Eduarda Ferreira
Legard, Chloe
Fisher, Grace
Simmons-Jones, Fiona
Oliver-Williams, Clare
author_sort Kyriacou, Harry
collection PubMed
description AIMS: Miscarriage and stillbirth have been included in cardiovascular disease (CVD) risk guidelines, however heterogeneity in exposures and outcomes and the absence of reviews assessing induced abortion, prevented comprehensive assessment. We aimed to perform a systematic review and meta-analysis of the risk of cardiovascular diseases for women with prior pregnancy loss (miscarriage, stillbirth, and induced abortion). METHODS AND RESULTS: Observational studies reporting risk of CVD, coronary heart disease (CHD), and stroke in women with pregnancy loss were selected after searching MEDLINE, Scopus, CINAHL, Web of Knowledge, and Cochrane Library (to January 2020). Data were extracted, and study quality were assessed using the Newcastle-Ottawa Scale. Pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated using inverse variance weighted random-effects meta-analysis. Twenty-two studies involving 4 337 683 women were identified. Seven studies were good quality, seven were fair and eight were poor. Recurrent miscarriage was associated with a higher CHD risk (RR = 1.37, 95% CI: 1.12–1.66). One or more stillbirths was associated with a higher CVD (RR = 1.41, 95% CI: 1.09–1.82), CHD (RR = 1.51, 95% CI: 1.04–1.29), and stroke risk (RR = 1.33, 95% CI: 1.03–1.71). Recurrent stillbirth was associated with a higher CHD risk (RR = 1.28, 95% CI: 1.18–1.39). One or more abortions was associated with a higher CVD (RR = 1.04, 95% CI: 1.02–1.07), as was recurrent abortion (RR = 1.09, 95% CI: 1.05–1.13). CONCLUSION: Women with previous pregnancy loss are at a higher CVD, CHD, and stroke risk. Early identification and risk factor management is recommended. Further research is needed to understand CVD risk after abortion.
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spelling pubmed-96174752022-11-02 The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis Kyriacou, Harry Al-Mohammad, Abdulrahman Muehlschlegel, Charlotte Foster-Davies, Lowri Bruco, Maria Eduarda Ferreira Legard, Chloe Fisher, Grace Simmons-Jones, Fiona Oliver-Williams, Clare Eur Heart J Open Original Article AIMS: Miscarriage and stillbirth have been included in cardiovascular disease (CVD) risk guidelines, however heterogeneity in exposures and outcomes and the absence of reviews assessing induced abortion, prevented comprehensive assessment. We aimed to perform a systematic review and meta-analysis of the risk of cardiovascular diseases for women with prior pregnancy loss (miscarriage, stillbirth, and induced abortion). METHODS AND RESULTS: Observational studies reporting risk of CVD, coronary heart disease (CHD), and stroke in women with pregnancy loss were selected after searching MEDLINE, Scopus, CINAHL, Web of Knowledge, and Cochrane Library (to January 2020). Data were extracted, and study quality were assessed using the Newcastle-Ottawa Scale. Pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated using inverse variance weighted random-effects meta-analysis. Twenty-two studies involving 4 337 683 women were identified. Seven studies were good quality, seven were fair and eight were poor. Recurrent miscarriage was associated with a higher CHD risk (RR = 1.37, 95% CI: 1.12–1.66). One or more stillbirths was associated with a higher CVD (RR = 1.41, 95% CI: 1.09–1.82), CHD (RR = 1.51, 95% CI: 1.04–1.29), and stroke risk (RR = 1.33, 95% CI: 1.03–1.71). Recurrent stillbirth was associated with a higher CHD risk (RR = 1.28, 95% CI: 1.18–1.39). One or more abortions was associated with a higher CVD (RR = 1.04, 95% CI: 1.02–1.07), as was recurrent abortion (RR = 1.09, 95% CI: 1.05–1.13). CONCLUSION: Women with previous pregnancy loss are at a higher CVD, CHD, and stroke risk. Early identification and risk factor management is recommended. Further research is needed to understand CVD risk after abortion. Oxford University Press 2022-10-05 /pmc/articles/PMC9617475/ /pubmed/36330356 http://dx.doi.org/10.1093/ehjopen/oeac065 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Kyriacou, Harry
Al-Mohammad, Abdulrahman
Muehlschlegel, Charlotte
Foster-Davies, Lowri
Bruco, Maria Eduarda Ferreira
Legard, Chloe
Fisher, Grace
Simmons-Jones, Fiona
Oliver-Williams, Clare
The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
title The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
title_full The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
title_fullStr The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
title_full_unstemmed The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
title_short The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
title_sort risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617475/
https://www.ncbi.nlm.nih.gov/pubmed/36330356
http://dx.doi.org/10.1093/ehjopen/oeac065
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