Pregnancy loss and risk of ischaemic stroke and myocardial infarction
Pregnancy loss and risk of ischaemic stroke and myocardial infarction
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DOI：
10.1111/bjh.14043
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发表时间：
2016-07-01
影响因子：
6.5
通讯作者：
Rosendaal, Frits R.
中科院分区：
文献类型：
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作者：
Maino, Alberto;Siegerink, Bob;Rosendaal, Frits R.
我们调查了妊娠丢失是否会增加年轻女性动脉血栓形成的风险。在对照组中，比较了患有缺血性中风(IS)或心肌梗死(MI)且至少有一次妊娠的妇女(年龄18-50岁)的妊娠丢失情况。校正了匹配变量、心血管危险因素、心血管家族史和抗磷脂抗体的优势比(OR)，95%可信区间(CI)，计算了妊娠丢失的数量和不成功妊娠的类型(早期流产、晚期流产和死产)。其中IS组165例，MI组218例，对照组743例。多胎流产(>；=3)妇女动脉血栓形成的风险是未流产妇女的两倍(OR 2.37，95%CI 0.99-5.70)，与死产妇女相似(OR 1.68，95%CI 0.79-3.55)。两种相对危险度(OR3.51，95%CI 1.08~11.35和2.06，95%CI 0.81~5.23)均高于MI(OR 2.04，95%CI 0.71~5.86和1.04，95%CI 0.39~2.79)。对抗磷脂抗体的调整不影响估计。即使考虑到其他心血管危险因素和抗磷脂抗体，多胎流产和死产也会增加IS的风险，并在较小程度上增加MI的风险。
We investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18-50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one pregnancy were compared for pregnancy loss in a control group. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for matching variables, cardiovascular risk factors, cardiovascular family history and the presence of antiphospholipid antibodies, were calculated for the number of pregnancy losses as well as the type of unsuccessful pregnancy (early miscarriage, late miscarriage and stillbirth). 165 IS cases, 218 MI cases and 743 controls were included. Women with multiple (>= 3) pregnancy loss had a doubled risk of arterial thrombosis (OR 2.37, 95% CI 0.99-5.70) compared with women without pregnancy loss, similarly to women who experienced stillbirth (OR 1.68, 95% CI 0.79-3.55). Both relative risks were higher for IS (OR 3.51, 95% CI 1.08-11.35 and 2.06, 95% CI 0.81-5.23, respectively) than for MI (OR 2.04, 95% CI 0.71-5.86 and 1.04, 95% CI 0.39-2.79). Adjustment for antiphospholipid antibodies did not affect the estimates. Multiple pregnancy loss and stillbirth increases the risk of IS and, to a lesser extent, of MI, even when other cardiovascular risk factors and antiphospholipid antibodies are accounted for.