Miscarriage (Spontaneous Abortion) Linked to Increased Early Death Risk

Highlights :

• Miscarriage (spontaneous abortion) is associated with the risk of dying younger
• Death rates are higher for women with three or more miscarriages
• Spontaneous abortion could be an early marker of future health risk in women

Women who miscarry are more likely to die prematurely (before 70 years of age) particularly from cardiovascular disease than women with other pregnancy outcomes.

Miscarriage or Spontaneous Abortion

A miscarriage is the spontaneous loss of a fetus before the 20th week of pregnancy. It affects around 12-24% of pregnancies, making it one of the most common adverse pregnancy outcomes. Evidence from prior studies has shown that women with a history of miscarriage have a greater risk of high blood pressure, type 2 diabetes, and cardiovascular diseases. However, limited information is available on miscarriage as a risk of early death.

The research team analyzed data on 101,681 female nurses taking part in the ongoing Nurses' Health Study II whose pregnancies and health were followed over a 24-year period between 1993 and 2017.

The participants completed questionnaires on pregnancies, their outcomes, lifestyle factors, and health-related conditions every second year during the follow-up period.

Findings revealed:

• 25.6% (26,102) of participants had at least one pregnancy ending in miscarriage.
• 2,936 premature deaths among women, out of which 1,346 were cancer deaths, and 269 were cardiovascular disease deaths.
• Death rates from all-cause were higher for women with three or more miscarriages and women reporting their first miscarriage before the age of 24.

After taking into account other potentially influential factors, dietary and lifestyle characteristics, results showed that women who miscarried were 19% more likely to die prematurely than women who did not.

Particularly, women who miscarried early in their reproductive life or had multiple miscarriages had a higher risk of premature death.

Evaluation of cause-specific mortality revealed that the link between miscarriage and premature death was strongest for cardiovascular deaths, with a 48% increased risk. However, no association was found for premature death from cancer.

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The authors state, "Our results suggest that spontaneous abortion could be an early marker of future health risk in women, including premature death.”

They conclude that further research is required to establish how spontaneous abortion is related to women's long-term health and the mechanisms underlying these relations.

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Limitations of the study include:

This is an observational study, so can't establish the cause

• It’s unknown whether miscarriages merely unmask pre-existing risks or instead triggers/accelerates the development of premature death.

Tips for a Healthy Pregnancy

Miscarriage can be prevented in most cases. Improve your chances of a healthy pregnancy and reduce miscarriage risk with these simple health tips:

• Take folic acid supplements to reduce the risk of birth defects
• Avoid smoking, alcohol, drug use, exposure to second-hand smoke
• Stay hydrated
• Increase the intake of fruits and vegetables
• Limit caffeine intake to 300 mg or less per day
• Maintain a healthy weight

References:

1. Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study: Yi-Xin Wang et al: BMJ 2021: (https://doi.org/10.1136/bmj.n530)
2. 12 Ways to Stay Healthy During Pregnancy - (https://brighamhealthhub.org/12-ways-to-stay-healthy-during-pregnancy/)

Source-Medindia