Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study
Background Pregnancy loss has been associated with myocardial infarction, stroke, and all‐cause mortality in women through unknown mechanisms. The aim of this study was to examine these associations in women and their male partners. Methods and Results In this register‐based cohort study, all people...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.028620 |
| _version_ | 1797738416223289344 |
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| author | Anders Pretzmann Mikkelsen Pia Egerup Astrid Marie Kolte David Westergaard Christian Torp‐Pedersen Henriette Svarre Nielsen Øjvind Lidegaard |
| author_facet | Anders Pretzmann Mikkelsen Pia Egerup Astrid Marie Kolte David Westergaard Christian Torp‐Pedersen Henriette Svarre Nielsen Øjvind Lidegaard |
| author_sort | Anders Pretzmann Mikkelsen |
| collection | DOAJ |
| description | Background Pregnancy loss has been associated with myocardial infarction, stroke, and all‐cause mortality in women through unknown mechanisms. The aim of this study was to examine these associations in women and their male partners. Methods and Results In this register‐based cohort study, all people born between 1957 and 1997, residing in Denmark between 1977 and 2017, and with a registered partner of the opposite sex were eligible for inclusion. Male partners through cohabitation, marriage, or paternity constituted the male cohort. Exposure to pregnancy loss was categorized as follows: 0, 1, 2, or ≥3 pregnancy losses. The outcomes of interest were myocardial infarction, stroke, and all‐cause mortality. The Cox proportional hazards model estimated hazard ratios (HRs), adjusted for age, calendar year, parity, and parental history of myocardial infarction or stroke. During follow‐up, 1 112 507 women experienced 4463 events of myocardial infarction compared with 13 838 events among 1 120 029 male partners. With the no pregnancy loss group as reference, the adjusted HRs of myocardial infarction in the female cohort after 1, 2, and ≥3 pregnancy losses were as follows: 1.1 (95% CI, 1.0–1.2), 1.3 (95% CI, 1.1–1.5), and 1.4 (95% CI, 1.1–1.8), respectively. In the male partner cohort, the corresponding estimates were 1.0 (95% CI, 1.0–1.1), 1.1 (95% CI, 1.0–1.2), and 1.0 (95% CI, 0.8–1.2), respectively. The outcome of stroke showed similar results. Pregnancy loss was not significantly associated with increased mortality in either sex. Conclusions Pregnancy loss or stillbirth was significantly associated with myocardial infarction and stroke in women but not their male partners. Pregnancy loss or stillbirth was not significantly associated with all‐cause mortality in women or male partners. |
| first_indexed | 2024-03-12T13:43:27Z |
| format | Article |
| id | doaj.art-c0dcc9fd9a884faeadb198808a77265d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-12T13:43:27Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c0dcc9fd9a884faeadb198808a77265d2023-08-23T10:41:23ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-08-01121510.1161/JAHA.122.028620Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort StudyAnders Pretzmann Mikkelsen0Pia Egerup1Astrid Marie Kolte2David Westergaard3Christian Torp‐Pedersen4Henriette Svarre Nielsen5Øjvind Lidegaard6Department of Gynaecology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkDepartment of Obstetrics and Gynaecology Copenhagen University Hospital Hvidovre Hvidovre DenmarkDepartment of Obstetrics and Gynaecology Copenhagen University Hospital Hvidovre Hvidovre DenmarkNovo Nordisk Foundation Center for Protein Research University of Copenhagen Copenhagen DenmarkDepartment of Cardiology and Clinical Research, Nordsjaellands Hospital Hillerød DenmarkDepartment of Obstetrics and Gynaecology Copenhagen University Hospital Hvidovre Hvidovre DenmarkDepartment of Gynaecology Copenhagen University Hospital–Rigshospitalet Copenhagen DenmarkBackground Pregnancy loss has been associated with myocardial infarction, stroke, and all‐cause mortality in women through unknown mechanisms. The aim of this study was to examine these associations in women and their male partners. Methods and Results In this register‐based cohort study, all people born between 1957 and 1997, residing in Denmark between 1977 and 2017, and with a registered partner of the opposite sex were eligible for inclusion. Male partners through cohabitation, marriage, or paternity constituted the male cohort. Exposure to pregnancy loss was categorized as follows: 0, 1, 2, or ≥3 pregnancy losses. The outcomes of interest were myocardial infarction, stroke, and all‐cause mortality. The Cox proportional hazards model estimated hazard ratios (HRs), adjusted for age, calendar year, parity, and parental history of myocardial infarction or stroke. During follow‐up, 1 112 507 women experienced 4463 events of myocardial infarction compared with 13 838 events among 1 120 029 male partners. With the no pregnancy loss group as reference, the adjusted HRs of myocardial infarction in the female cohort after 1, 2, and ≥3 pregnancy losses were as follows: 1.1 (95% CI, 1.0–1.2), 1.3 (95% CI, 1.1–1.5), and 1.4 (95% CI, 1.1–1.8), respectively. In the male partner cohort, the corresponding estimates were 1.0 (95% CI, 1.0–1.1), 1.1 (95% CI, 1.0–1.2), and 1.0 (95% CI, 0.8–1.2), respectively. The outcome of stroke showed similar results. Pregnancy loss was not significantly associated with increased mortality in either sex. Conclusions Pregnancy loss or stillbirth was significantly associated with myocardial infarction and stroke in women but not their male partners. Pregnancy loss or stillbirth was not significantly associated with all‐cause mortality in women or male partners.https://www.ahajournals.org/doi/10.1161/JAHA.122.028620epidemiologymiscarriagemyocardial infarctionpregnancy lossstroke |
| spellingShingle | Anders Pretzmann Mikkelsen Pia Egerup Astrid Marie Kolte David Westergaard Christian Torp‐Pedersen Henriette Svarre Nielsen Øjvind Lidegaard Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease epidemiology miscarriage myocardial infarction pregnancy loss stroke |
| title | Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study |
| title_full | Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study |
| title_fullStr | Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study |
| title_full_unstemmed | Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study |
| title_short | Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All‐Cause Mortality: A Nationwide Partner Comparison Cohort Study |
| title_sort | pregnancy loss and the risk of myocardial infarction stroke and all cause mortality a nationwide partner comparison cohort study |
| topic | epidemiology miscarriage myocardial infarction pregnancy loss stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.028620 |
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