Abstract 11522: The Risk of Cardiovascular Diseases in Women with Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis

Abstract

Introduction: Recurrent pregnancy loss (RPL) is defined as two or more ultrasound confirmed pregnancy losses or three or more pregnancy losses at any location. Evidence suggests that women with a history of RPL have an increased risk of coronary heart disease. However, the association between cardiovascular diseases (CVD) and RPL remains unclear. We aim to conduct a systematic review and meta-analysis to investigate whether RPL is a risk factor for CVD. Methods: Population-based studies on MEDLINE, CINAHL, Web of Science, and Embase that investigated the risk of CVD in women with or without a history of RPL were included. The incidences of CVD events and its composite endpoints myocardial infarction/coronary heart diseases (MI/CHD), stroke/cerebrovascular diseases (stroke/CeVD), circulatory system diseases (CSD) were extracted and presented with odds ratio (OR) with 95% confidence interval (CI). Heterogeneity was analyzed with I 2 . Results: A total of 809 articles were retrieved and 6 studies were included. The incidences of CVD events was significantly increased (OR=1.49, 95% CI 1.11 to 1.99, P=0.008, I 2 =96%) in 13176 women with RPL (≥2 pregnancy losses) compare to 403278 controls; a borderline increase of MI/CHD risk was also found (OR=1.45, 95% CI 1.00 to 2.08, P=0.05, I 2 =78%), whereas no significant differences of stroke/CeVD (OR=1.25, 95% CI 0.79 to 1.98, P=0.35, I 2 =73%) and CSD risks (OR=1.17, 95% CI 0.83 to 1.67, P=0.05, I 2 =93%) were observed. In 1594 women with three or more pregnancy losses, an increased incidence of CVD events was found compared to 311385 women without (OR=1.59, 95% CI 1.04 to 2.40, P=0.03, I 2 =71%). The risks of MI/CHD (OR=3.03, 95% CI 1.45 to 6.35, P=0.003, I 2 =78%) and stroke/CeVD (OR=1.63, 95% CI 1.38 to 1.93, P<0.00001, I 2 =0%) were significantly increased in these women but not CSD (OR=1.27, 95% CI 0.92 to 1.76, P=0.13, I 2 =57%). Conclusion: Our study suggested an association between RPL and increased risks of CVD and MI/CHD. The risks of stroke/CeVD may be elevated in women with three or more pregnancy losses. Our work provides a better understanding of the sex-specific risk factors of CVD. Further research may help to identify the causal link between RPL and CVD and determine the need for early screening and intervention in women at risk.