Studies that evaluated the association between miscarriage and CHD
| Author and publication date (country) | Study design | Duration of follow-up | Outcome | Exposure | Number of cases | Number of non-cases | Result (OR/HR and 95% CI) | Covariates adjusted/matched on/stratified by |
|---|---|---|---|---|---|---|---|---|
| History of miscarriage | ||||||||
| Bengtsson et al (1973)17 (Sweden)* | Community-based case-control | – | Acute MI | History of miscarriage | 44 | 578 | 2.46 (1.31 to 4.63) | None |
| Bertuccio et al (2007)18 (Italy)† | Hospital-based case-control | – | First episode non-fatal AMI | History of miscarriage | 609 | 1106 | 1.18 (0.94 to 1.48) | None |
| Cooper et al (1999)19 (USA) | Prospective cohort | 52 years | MI, angioplasty, heart bypass, CHD mortality (ICD-9 codes 410–414) | History of miscarriage | 45 | 822 | 1.36 (0.71 to 2.61) | Age |
| Kharazmi et al (2010)20 (Finland) | Community-based case-control | – | MI and angina | History of miscarriage | 112 | 3704 | 1.2 (0.6 to 2.4) | Age, education, BMI, WHR, number of previous pregnancies, smoking, blood pressure, fasting blood glucose, total and LDL cholesterol and physical activity |
| Kharazmi et al (2011)21 (Germany) | Prospective cohort study | 12 years | MI (ICD-10 codes I21.0- I21.4 and I21.9) | History of miscarriage | 79 | 11 439 | 1.18 (0.69 to 2.04) | Age, education, BMI, WHR, number of previous pregnancies, smoking, alcohol, physical activity, history of hypertension, diabetes mellitus and hyperlipidaemia |
| Smith et al (2003)15 (Scotland) | Retrospective cohort | 18 years | CHD | History of miscarriage (prior first live birth) | 313 | 128 977 | 1.52 (1.13 to 2.06) | Age at first birth, SEC, lowest fifth of birthweight distribution, preterm delivery, preeclampsia, essential hypertension in first pregnancy and height |
| Winkelstein et al (1958)22 (USA)‡ | Community-based matched case-control | – | MI and positive ECG findings | History of miscarriage | 50 | 50 | 3.17 (1.35 to 7.44) | None |
| Winkelstein and Rekate (1964)23 (USA) | Hospital-based case-control | – | CHD (ICD-7 codes: 420.0–420.2 | History of miscarriage | 59 | 64 | 1.61 (0.79 to 3.31) | None |
| Recurrent miscarriage | ||||||||
| Bengtsson et al (1973)17 (Sweden)* | Community-based case-control | – | Acute MI | Recurrent miscarriage (3+) | 27 | 462 | 1.45 (0.18 to 11.55) | None |
| Bertuccio et al (2007)18 (Italy)† | Hospital-based case-control | – | First episode non-fatal AMI | Recurrent miscarriage (2+) | 499 | 936 | 0.92 (0.62 to 1.38) | Age, study, education, BMI, smoking, coffee and alcohol drinking, cholesterol levels, diabetes, obesity, hyperlipidaemia, hypertension, parity, menopausal status/age at menopause, HRT and family history of AMI in first degree relatives |
| Gallagher et al (2011)24 (China) | Prospective cohort | 11 years | CHD (ICD-9 codes 410–414) | Recurrent miscarriage (2+) | 374 | 240 800§ | 1.27 (0.84 to 1.92) | Age |
| Kharazmi et al (2011)21 (Germany) | Prospective cohort study | 12 years | MI (ICD-10 codes I21.0, I21.4, I21.9) | Recurrent miscarriage (3+) | 57 | 8218 | 5.06 (1.26 to 20.29) | Age, education, BMI, WHR, number of previous pregnancies, smoking, alcohol, physical activity, history of hypertension, diabetes mellitus and hyperlipidaemia |
| Smith et al (2003)15 (Scotland) | Retrospective cohort | 18 years | CHD | Recurrent miscarriage (3+ prior first live birth) | 265 | 117 654 | 2.35 (0.87 to 6.36) | Age at first birth, SEC, lowest fifth of birthweight distribution, preterm delivery, preeclampsia, essential hypertension in first pregnancy and height |
| Winkelstein et al (1958)22 (USA)‡ | Community-based matched case-control | – | MI and positive ECG findings | Recurrent miscarriage (3+) | 35 | 42 | 3.80 (1.07 to 13.46) | None |
| Winkelstein and Rekate (1964)23 (USA) | Hospital-based case-control | – | CHD (ICD-7 codes: 420.0, 420.1, 420.2) | Recurrent miscarriage (3+) | 43 | 41 | 17.33 (2.15 to 139.88) | None |
*Both spontaneous and therapeutic abortions combined.
†Data combined from three studies.
‡Ignored matching when calculating OR.
§Estimated from person-years, as data not provided.
AMI, acute myocardial infarction; BMI, body mass index; CHD, coronary heart disease; HRT, hormone replacement therapy; ICD, International Classification of Diseases; LDL, low density lipoprotein; MI, myocardial infarction; SEC, socioeconomic class; WHR, waist to hip ratio.