Infertility Or Miscarriage Can Raise A Woman’s Risk Of Stroke
An analysis of observational studies found a connection between infertility, miscarriage, and an increased risk of both non-fatal and fatal strokes in old age.
The weekly peer-reviewed medical magazine BMJ reported the findings.
The researchers propose that early surveillance of women who have had a miscarriage or stillbirth, together with modifications to a healthy lifestyle, could reduce the incidence of stroke.
One of the top causes of death and disability for women worldwide is stroke. About 3 million women suffered stroke deaths in 2019. In addition, women lost 10 million years of healthy living in total due to disability after a stroke, which is 44% more years than men did.
The purpose of this study was to close any existing gaps by examining the relationship between infertility, miscarriage, and stillbirth and the risk of both fatal and non-fatal strokes as well as specific types of stroke.
The researchers examined data from a total of 27 studies from the InterLACE consortium, which compiles information on chronic illness and reproductive health. The research used information from eight studies conducted in seven nations (Australia, China, Japan, the Netherlands, Sweden, the UK, and the USA).
Information on infertility, miscarriage, and stillbirth was gathered using questionnaires. Using self-reported surveys or medical data, information about non-fatal strokes was also discovered. The identification of fatal stroke cases and stroke subtypes was done using hospital data (haemorrhagic or ischaemic).
In total, 620,000 women who ranged in age from 32 to 73 were enrolled in the study.
Of these, 54,716 women only had information on non-fatal stroke, 288,272 women only had information on fatal stroke, and 275,863 women had information on both types of stroke. Among them, 4,003 (0.7%) had a fatal stroke at a median age of 71, and 9,265 (2.8%) women had their first non-fatal stroke at a median age of 62.
Women under the age of 40 who had non-fatal strokes were disqualified because they might have experienced a stroke before a history of infertility, miscarriage, or stillbirth could be established. The results were also adjusted for a number of variables, including race, weight, lifestyle, and underlying illnesses.
The study indicates that miscarriage, stillbirth, and infertility are all linked to an elevated risk of stroke, particularly recurrent miscarriages (three or more) and stillbirths.
A non-fatal stroke was 14% more likely to occur in women with a history of infertility than in those without such a history.
The increased risk of non-fatal ischemic and hemorrhagic stroke was 37% and 41% for women who experienced three or more miscarriages, respectively. Similar results were seen for fatal ischemic and hemorrhagic stroke, where having three or more miscarriages was associated with an increase in risk of 83% and 84%, respectively.
Women who had two or more stillbirths were about 80% more likely to have a non-fatal ischemic stroke, and those with a history of stillbirth had a risk of non-fatal stroke that was over 30% greater.
The study also discovered that having several stillbirths was linked to a fatal stroke risk that was over 40% greater.
Since this study is an observational one, a cause cannot be determined. Other drawbacks of the study include the use of questionnaires as the primary data collection method, the lack of sufficient data to investigate the impact of other treatments, and the possibility that various studies have different definitions of infertility, stillbirth, and miscarriage.
Nevertheless, the results of this huge, carefully planned study remained virtually unaltered after additional analyses, indicating that the conclusions are reliable.
“Having a history of recurrent pregnancy loss may be viewed as a female-specific risk factor for stroke,” the researchers write.
Additionally, they contend that encouraging good lifestyle choices and early monitoring of women with a history of miscarriage or infertility may assist to reduce their risk of stroke in later life.
