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Miscarriage, stillbirth, and mortality risk from stroke in women: findings from the PLCO study
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Hui Tang, Zhou Li, Yuan Zhang, Mingjun Dai, Xiaoya Wang, Chuan Shao
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Epidemiol Health. 2024;e2024093. Published online November 25, 2024
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DOI: https://doi.org/10.4178/epih.e2024093
[Accepted]
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 Abstract
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Abstract
OBJECTIVES
Existing evidence suggests that miscarriage and stillbirth are associated with an increased risk of stroke in women. However, the impact of these events on stroke mortality remains unclear. This study aimed to elucidate the potential association between miscarriage and stillbirth and stroke mortality in women.
METHODS We employed a competing risk model using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial to assess the relationship between miscarriage/stillbirth and stroke death. Death from other causes was considered as a competing risk, and we conducted a subgroup analysis to explore the potential impact.
RESULTS Our study included 68,629 women for miscarriage and 65,343 women for stillbirth. No significant association was observed between miscarriage and stroke mortality (hazard ratio [HR]=0.96; 95% confidence interval [CI], 0.84-1.10; p=0.58). While a single stillbirth did not show a significant association (HR=1.07; 95% CI, 0.81-1.41, p=0.63), recurrent stillbirth (≥2) was associated with a significantly increased risk of stroke mortality compared to women with no stillbirths (HR=2.24; 95% CI, 1.45-3.46, p<0.001).
CONCLUSIONS Our findings suggest that recurrent stillbirth, but not single events, is associated with an elevated risk of stroke mortality in women. Further research is warranted to clarify the underlying mechanisms and potential long-term health implications of recurrent pregnancy loss.
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