School of Environmental Science and Engineering, Hainan University, Haikou, Hainan, 570228, China.
Vanke School of Public Health, Tsinghua University, Zhongguancun North Street, Haidian District, Beijing, 100084, China.
BMC Public Health. 2024 Oct 2;24(1):2694. doi: 10.1186/s12889-024-20199-0.
While the association between pregnancy loss and individual cardiometabolic diseases (CMDs) is well-established, its impact on the risk of coexisting CMDs remains unclear. Therefore, the aim of this study is to investigate the association between pregnancy loss with the risk of cardiometabolic multimorbidity in Chinese women.
We analyzed the cross-sectional data of 299,582 female participants aged 30-79 years old from the China Kadoorie biobank. Cardiometabolic multimorbidity was defined as the coexistence of two or more CMDs, including coronary heart disease, stroke, hypertension, and diabetes. Multivariable logistic regression was used to evaluate the odds ratios (ORs) between the number and type of pregnancy loss with the risk of cardiometabolic multimorbidity, characterized by the number and type of CMD.
After adjusting for confounding factors, pregnancy loss was found to be significantly associated with increased cardiometabolic multimorbidity risk (OR, 1.13 95% CI 1.08-1.19). Specifically, pregnancy loss due to spontaneous and induced abortion (OR 1.10, 95% CI 1.03-1.18 and OR 1.13, 95% CI 1.08-1.19, respectively). In contrast, no significant association was found between stillbirth and cardiometabolic multimorbidity (OR 1.03, 95% CI 0.95-1.11). The risk of cardiometabolic multimorbidity increases as the number of pregnancy loss increases (one pregnancy loss: OR 1.10, 95% CI 1.05-1.16, two or more pregnancy loss: OR 1.16, 95% CI 1.10-1.22). Similarly, the diagnosis of multiple CMDs increases with increasing number of pregnancy loss. Pregnancy loss was related to higher risk of cardiometabolic multimorbidity across most CMD combinations of CMDs.
Pregnancy loss, in particular, spontaneous and induced abortion was significantly associated with greater risk of cardiometabolic multimorbidity. The associations were stronger among those with recurrent pregnancy loss.
虽然妊娠丢失与个体心血管代谢疾病（CMD）之间的关联已得到充分证实，但它对共存 CMD 风险的影响尚不清楚。因此，本研究旨在探讨中国女性妊娠丢失与心血管代谢性多种疾病风险之间的关系。
我们分析了来自中国慢性病前瞻性研究的 299582 名 30-79 岁女性参与者的横断面数据。心血管代谢性多种疾病定义为两种或多种 CMD 的共存，包括冠心病、中风、高血压和糖尿病。多变量逻辑回归用于评估妊娠丢失次数和类型与心血管代谢性多种疾病风险之间的比值比（OR），其特征是 CMD 的数量和类型。
调整混杂因素后，妊娠丢失与心血管代谢性多种疾病风险显著相关（OR，1.13；95%CI，1.08-1.19）。具体而言，自然流产和人工流产引起的妊娠丢失（OR，1.10；95%CI，1.03-1.18 和 OR，1.13；95%CI，1.08-1.19）与心血管代谢性多种疾病风险增加相关。相比之下，死产与心血管代谢性多种疾病之间无显著关联（OR，1.03；95%CI，0.95-1.11）。随着妊娠丢失次数的增加，心血管代谢性多种疾病的风险也随之增加（一次妊娠丢失：OR，1.10；95%CI，1.05-1.16；两次或更多次妊娠丢失：OR，1.16；95%CI，1.10-1.22）。同样，随着妊娠丢失次数的增加，多种 CMD 的诊断也随之增加。妊娠丢失与大多数 CMD 组合的心血管代谢性多种疾病的风险增加相关。
妊娠丢失，特别是自然流产和人工流产与心血管代谢性多种疾病的风险增加显著相关。在反复妊娠丢失的人群中，这种关联更强。
