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Miscarriage Linked to Higher Risk for Premature Mortality

FRIDAY, March 26, 2021 -- Spontaneous abortion is associated with an elevated risk for premature mortality, according to a study published online March 24 in The BMJ.

Yi-Xin Wang, Ph.D., from the Harvard T. H. Chan School of Public Health in Boston, and colleagues conducted a prospective cohort study among 101,681 ever gravid female nurses participating in the Nurses' Health Study II to examine the association between spontaneous abortion and the risk for premature mortality before age 70 years.

The researchers recorded 2,936 premature deaths during 24 years of follow-up. Women with and without a history of spontaneous abortion had comparable crude all-cause mortality rates (1.24 per 1,000 person-years in both groups), but rates were higher for women experiencing three or more spontaneous abortions and for those reporting their first spontaneous abortion before age 24 years (1.47 and 1.69 per 1,000 person-years, respectively). The occurrence of spontaneous abortion was associated with a hazard ratio of 1.19 for premature mortality during follow-up, after adjustment for confounding factors and updated dietary and lifestyle factors. The association was stronger for recurrent spontaneous abortions (hazard ratios, 1.59, 1.23, and 1.16 for three or more, two, and one versus none, respectively) and for spontaneous abortions occurring early in a woman's reproductive life (hazard ratios, 1.32, 1.16, and 1.12 for age ≤23, 24 to 29, and ≥30 years, respectively). In the evaluation of cause-specific premature mortality, the association of spontaneous abortion with premature death was strongest for deaths from cardiovascular disease (hazard ratio, 1.48).

"Our results suggest that spontaneous abortion could be an early marker of future health risk in women, including premature death," the authors write.

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