Public Health. 2026 Apr 4;255:106290. doi: 10.1016/j.puhe.2026.106290. Online ahead of print.
ABSTRACT
OBJECTIVES: Adverse pregnancy outcomes such as miscarriage and stillbirth have been increasingly recognized as potential early indicators of cardiovascular risk in women. However, evidence remains inconsistent, particularly regarding age-specific patterns and cumulative exposure. This study aimed to investigate the associations between pregnancy loss (miscarriage, stillbirth, and termination) and incident cardiovascular disease (CVD) in the UK Biobank cohort.
STUDY DESIGN: Prospective population-based cohort study.
METHODS: We analyzed 128,869 women without prior CVD at baseline (2006-2010). Pregnancy loss was self-reported and categorized as miscarriage, stillbirth, or termination. Incident CVD events, including hypertension, diabetes, coronary artery disease (CAD), myocardial infarction (MI), ischemic stroke, and heart failure, were identified through linked hospital records. Multivariable Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for sociodemographic, behavioral, and clinical covariates. Analyses were stratified by age group and number of pregnancy losses.
RESULTS: Over a median follow-up of 11.9 years, pregnancy loss was associated with increased risk of hypertension (HR 1.14; 95% CI 1.08-1.21), particularly among women aged <50 and >60 years. Stillbirth was associated with hypertension (HR 1.27; 95% CI 1.09-1.48) and diabetes in younger women (HR 2.15; 95% CI 1.02-4.52). Miscarriage was associated with CAD (HR 1.12; 95% CI 1.02-1.37). No significant associations were observed for termination. Limited dose-response patterns were identified for recurrent stillbirth.
CONCLUSIONS: Pregnancy loss, especially stillbirth and miscarriage, was independently associated with selected cardiovascular outcomes. Reproductive history may improve cardiovascular risk assessment in women.
PMID:41936768 | DOI:10.1016/j.puhe.2026.106290