Reproductive medicine specialist Dr. Yacoub Khalaf who was not involved in the study, said that among women trying to get pregnant, miscarriage was an difficulty to be managed, and its implications should be taken seriously.
“Our results suggest that spontaneous abortion could be an early marker of future health risk in women, including premature death. More research is needed to establish how spontaneous abortion is related to women’s long term health and the mechanisms underlying these relations,” the authors write.
Studies like this are important because they look at all causes of mortality in young reproductive aged women who had experienced miscarriages rather than determining death rates by comparing those with miscarriages against those without them or looking at specific causes of death.
Dr. Yacoub Khalaf, a reproductive medicine specialist at Fertility First in New York who was not involved in the study, said that among women trying to get pregnant, miscarriage was an difficulty to be managed, and its implications should be taken seriously. “Our results suggest that spontaneous abortion could be an early marker of future health risk in women, including premature death,” he said. More research is needed to establish how these miscarriages are related to women’s long term health and the mechanisms underlying these relations.”
In a large study that followed almost 400,000 women for two decades, researchers found that women who had been pregnant and suffered from a miscarriage were at increased risk of early death compared with those in the general population.
The team in Denmark has published their results in the British Journal of General Practice. They say the link may be explained by poorer health before pregnancy or other factors related to childbearing.
In an editorial, Drs Anick Berard and Beverley Chalmers from Canada’s University of Montreal say it is difficult to rule out underlying conditions affecting both reproductive and general health as plausible explanations for the findings. A new study suggests that the likelihood of dying during a woman’s lifetime is increased if she has had one or more miscarriages.
The research also shows that women who have three or more miscarriages are four times as likely to die prematurely in comparison with women whose pregnancies are not affected by loss.
The findings, appearing today in the British Medical Journal, are based on data from over 30 years involving nearly 1 million Danish women between the ages of 15 and 49. The investigators found that 12% of women at risk for pregnancy experienced miscarriage before 20 weeks gestation, while 3% suffered fetal death in utero after 20 weeks.
Outcomes were adjusted for maternal age, year of birth, length of education, smoking status and previous births/pregnancies. The study showed that women who had suffered a miscarriage before 20 weeks experienced an 83% increased risk of dying during any given year, compared with women without a history of pregnancy loss.
As for late fetal death, the same group was found to face a 277% greater risk of dying early. Among women who had experienced three or more miscarriages by 20 weeks, the researchers found their mortality rate was 4 times higher than among peers without such adverse outcomes.
By comparison, women experiencing one miscarriage were 2.8 times as likely to die during any given year as those who have not lost pregnancies, while there was no elevated risk associated with two or more miscarriages prior to 20 weeks’ gestation.
According to lead author Professor James Trussell, Director of the Office of Population Research at Princeton University in New Jersey, US: ‘The increased mortality among women who had experienced one or more miscarriage was particularly shocking to the investigators.’
He added that it is unclear why some women are more likely than others to experience losses.
‘These events, although very traumatic for mothers and their families, are far less common than miscarriages during early pregnancy,’ Prof Trussell said.
‘I hope that our findings will remind physicians that patients should be questioned about previous miscarriages when assessing risk factors for mortality.’