Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study

Objective: To determine whether women experiencing recurrent miscarriage were more likely to have a family history of cardiovascular disease.

Design: Retrospective cohort study.

Setting: Women having a first birth in Scotland between 1992 and 2006.

Sample: A total of 74, 730 first births were linked to the hospital admission and death certification data for the women's parents through the women's birth certificates.

Methods: The incidence of cardiovascular disease in the women's parents was related to the number of miscarriages experienced before their daughters' first births using a Cox proportional hazards model.

Main outcome measures: Death or hospital admission of the women's parents for ischaemic heart disease (IHD), cerebrovascular disease (CVD) or venous thromboembolism (VTE).

Main results: There was an increased incidence of IHD in the parents of women who experienced two miscarriages before their first birth (hazard ratio 1.25, 95% CI 1.04-1.49) and parents of women who experienced three or more miscarriages before their first birth (hazard ratio 1.56, 95% CI 1.14-2.15). Adjustment for the characteristics of the women at the time of the first birth was without material effect. There was no significant association between miscarriage and family history of CVD or VTE. There was no significant association between the number of therapeutic terminations of pregnancy before the first birth and the incidence of any type of cardiovascular disease in the women's parents.

Conclusions: The parents of women who experience recurrent miscarriage are more likely to experience IHD. Recurrent miscarriage and IHD may have common patho-physiological pathways and genetic predispositions.