Infertility, miscarriage, may increase stroke risk in women —Study

A new study has indicated that women who have experienced infertility, recurrent miscarriage, and loss of a baby before or during birth could be at a higher risk of stroke.

According to the researchers, early monitoring of these women, as well as healthy lifestyle changes, could lessen the risk of stroke. 

The researchers conducted the study using data from eight studies from seven countries namely; Australia, China, Japan, Netherlands, Sweden, the United Kingdom, and the United States.

The researchers analysed the data from the InterLACE consortium which was established in June 2012 and provides pooled individual-level data on reproductive health and chronic disease.

The cohort study already published in the BMJ Journal consisted of 618,851 women aged 32 to 73 years with a history of infertility, miscarriage, or stillbirth and at least one outcome event, non-fatal or fatal stroke.

Data for non-fatal strokes was gathered using self-reported questionnaires or hospital records and fatal strokes were identified through death registry data.

The researchers noted that 93,119 women were excluded and of the remaining participants, 54,716 only had data on non-fatal stroke and 288,272 only had data on fatal stroke.

In addition, the researchers said factors that could have altered the results such as ethnicity, weight, smoking status, education level, and underlying conditions were considered.

According to findings from the study, women with a history of infertility were at 14 per cent increased risk of non-fatal stroke, women with stillbirth were at 31 per cent higher risk of non-fatal stroke and women with recurrent loss of a baby before or during birth were at 26 per cent higher risk of fatal stroke.

Also, recurrent miscarriage was associated with an 11 per cent higher risk of non-fatal and fatal stroke compared to women who had not had a miscarriage. The risk of stroke rose with the number of miscarriages a woman had: one, two, and three miscarriages led to a 7 per cent, 12 per cent, and 35 per cent increase respectively.

The reseachers in the study report said, “Globally, stroke is one of the leading causes of mortality and disability in women. 

“In 2019, around three million women died from a stroke, and women lost over 10 million years of healthy life due to disability caused by stroke — 44 per cent higher than the number for men.”

“Current stroke prevention guidelines have identified some risk factors, such as obesity, hypertension, and diabetes, but these are insufficient to explain the difference in risk of stroke between women and men.”

The lead study author, a professor of Life Course Epidemiology at the University of Queensland, Dr. Gita Mishra, said, “Infertility and pregnancy loss, especially recurrent miscarriages, and stillbirths, were associated with women’s later risk of non-fatal and fatal stroke.

“The risk of stroke (non-fatal or fatal) associated with infertility or recurrent stillbirths were mainly driven by a single subtype of stroke (a non-fatal ischaemic stroke or fatal haemorrhagic stroke, respectively), whereas the risk of stroke (non-fatal or fatal) associated with recurrent miscarriages was driven by both subtypes.

“These findings extend our current knowledge on the associations of infertility, miscarriage, and stillbirth with stroke, and highlight the need for future studies on the underlying mechanisms, linking the subtype, severity, and prognosis of stroke.

“A history of recurrent miscarriages and death or loss of a baby before or during birth should be considered a female-specific risk factor for stroke. Early monitoring of women with recurrent miscarriages or stillbirths and tailored healthy lifestyle interventions are recommended to lower the risk of stroke,” she said.

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