Effects of Prior Reproductive Losses on Risk of Cardiovascular Diseases Within Six Months of a First Live Birth

Pregnancy affects cardiovascular health. It is associated with increased long-term risk of hypertension¹, ischemic heart disease (IHD)¹, myocardial infarction (MI)^2–4, ischemic stroke and intracerebral hemorrhage^5–9, venous and arterial thromboembolism.^10,11 However, there is relatively little research exploring the differences in risks of cardiovascular disease (CVD) associated with pregnancy losses (induced or natural).^12–19

In recent analyses examining the effects of pregnancy on Medicaid recipients, we found that there was an 18% increased risk of a first diagnosis of CVD (Adjusted OR=1.18; 95% CI=1.15-1.21) among women whose first pregnancy was a pregnancy loss as compared to women whose first pregnancy was a live birth. A graph of the onset of first diagnosis of CVD, however, revealed that incremental increased risk was reversed only in the first six months following the first pregnancy outcome. In that first six months following a first pregnancy outcome, 3.61% of women giving birth had a first CVD diagnosis compared to only 2.04% of women who had a miscarriage or abortion. Biannual rates of first CVD fell for both groups after the first six months, but significantly more slowly for those who had a first pregnancy loss.²⁰

These findings introduced the question of whether a history of pregnancy loss increases the risk of CVD following a first live birth. Accordingly, the present study seeks to examine the effects of prior pregnancy loss on CVD risk in the first six months following a first live birth.