Stroke: Association of female infertility, miscarriage, stillbirth and stroke risk

Miscarriage and stillbirth are associated with an increased risk of stroke in women, and they can be used as a risk factor to help identify women at higher risk for stroke
.

Stroke is one of the leading causes of death, and in absolute numbers, women are more affected by stroke than men and have worse outcomes
.

A growing number of studies have explored the association between pregnancy complications, pregnancy outcomes, and stroke
.

However, only a few studies have investigated the association between infertility, miscarriage, and stillbirth, and stroke in women, and these associations may be related to endocrine disease, endothelial dysfunction, and chronic systemic inflammation
.

A research article was recently published in the journal Stroke, which aims to summarize current evidence and provide the latest findings on the association between infertility, miscarriage and stillbirth, and stroke incidence
.

As of September 26, 2020, we conducted a comprehensive literature search of cohort and case-control studies investigating the association between infertility, miscarriage, stillbirth, and stroke
.

Seven databases searched by the researchers: PubMed, Embase, Cochrane, CINIHL, PsyclNFO, Wanfang and CNKI
.

A random-effects model was used to estimate pooled hazard ratios (HR) and 95% CIs
.

This meta-analysis included 16 cohort studies and 2 case-control studies recruiting a total of 7,808,521 women
.

Women who experienced a miscarriage or stillbirth had a higher risk of stroke than other women (miscarriage: HR, 1.
07 [95% CI, 1.
00-1.
14]; stillbirth: HR, 1.
38 [95% CI, 1.
11-1.
71])
.

The HRs for stroke per additional miscarriage and stillbirth were 1.
13 (95% CI 0.
96-1.
33) and 1.
25 (95% CI 1.
06-1.
49), respectively
.

In subgroup analyses, increased risk of stroke was associated with recurrent miscarriage and stillbirth (≥3 miscarriages: HR 1.
42 [95% CI 1.
05-1.
90]; ≥2 stillbirths: HR 1.
14 [95% CI 1.
04] -1.
26])
.

The association between infertility and stroke was inconsistent and inconclusive (HR 1.
07 [95% CI 0.
87-1.
32])
.

CONCLUSIONS: Miscarriage and stillbirth are associated with an increased risk of stroke in women, and they can be used as a risk factor to help identify women at higher risk for stroke
.

Reference: Chen Liang.
et al.
Infertility, Miscarriage, Stillbirth, and the Risk of Stroke Among Women: A Systematic Review and Meta-Analysis.
stroke.
2021.
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