Department of Obstetrics, Leiden University Medical Center, Leiden, the Netherlands.
Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, the Netherlands.
Acta Obstet Gynecol Scand. 2018 Oct;97(10):1192-1199. doi: 10.1111/aogs.13392. Epub 2018 Jun 17.
Cardiovascular disease is the leading cause of death in women. Observational studies suggest that women with a history of recurrent miscarriage have an increased risk of cardiovascular disease.
Women who visited the recurrent miscarriage clinic at Leiden University Medical Center between 2000 and 2010 and who had their third consecutive miscarriage before the age of 31 years, were invited to participate in this follow-up study (between 2012 and 2014). The reference group consisted of women with at least one uncomplicated pregnancy and no miscarriage, matched by zip code, age, and date of pregnancy. All women were invited for risk factor screening, including physical examination and blood collection. Main outcome measures were the (extrapolated) 10- and 30-year cardiovascular risk scores using the Framingham risk score. A subanalysis was performed for women with idiopathic recurrent miscarriage.
Thirty-six women were included in both groups. Mean follow up was 7.5 years. Women with recurrent miscarriage had a significantly higher extrapolated 10-year cardiovascular risk score (mean 6.24%, SD 5.44) compared with women with no miscarriage (mean 3.56%, SD 1.82, P = .007) and a significantly higher 30-year cardiovascular risk score (mean 9.86%, SD 9.10) compared with women with no miscarriage (mean 6.39%, SD 4.20, P = .04). Similar results were found in women with idiopathic recurrent miscarriage (n = 28).
Women with a history of recurrent miscarriage differ in cardiovascular risk profile at a young age compared with women with no miscarriage. The findings support an opportunity to identify women at risk of cardiovascular disease later in life and a possible moment for intervention.
心血管疾病是女性死亡的主要原因。观察性研究表明，有反复流产史的女性患心血管疾病的风险增加。
莱顿大学医学中心的复发性流产诊所于 2000 年至 2010 年间就诊且在 31 岁之前连续发生第三次流产的女性被邀请参加这项随访研究（2012 年至 2014 年期间）。参考组由至少有一次无并发症妊娠且无流产史的女性组成，通过邮政编码、年龄和妊娠日期与对照组相匹配。所有女性均被邀请进行危险因素筛查，包括体格检查和采血。主要结局测量指标是使用弗雷明汉风险评分得出的（外推的）10 年和 30 年心血管风险评分。对特发性复发性流产的女性进行了亚分析。
两组各有 36 名女性入组。平均随访时间为 7.5 年。与无流产史的女性相比（平均 3.56%，SD 1.82，P=0.007），复发性流产的女性的外推 10 年心血管风险评分明显更高（平均 6.24%，SD 5.44），与无流产史的女性相比（平均 6.39%，SD 4.20，P=0.04），复发性流产的女性的 30 年心血管风险评分也明显更高。在特发性复发性流产的女性中（n=28）也发现了类似的结果。
与无流产史的女性相比，有反复流产史的女性在年轻时的心血管风险特征不同。这些发现支持了在以后的生活中识别有心血管疾病风险的女性的机会，以及进行干预的可能时机。
