Infertility and pregnancy loss risk factors for stroke in women

Infertility and pregnancy loss are associated with an increased risk of non-fatal and fatal stroke in later life. This is in accordance to an analysis of observational studies, published in The BMJ.Early monitoring of women who have experienced miscarriage or stillbirth, along with healthy lifestyle changes, could lower the risk of stroke.

Questionnaires were used to find information on infertility, miscarriage, and stillbirth. Hospital data were used to identify cases of fatal stroke, and subtypes of stroke.

Overall, over 6lac women were included in the study. And the study results highlighted that among these, 2.8% women experienced a first non-fatal stroke at a median age of 62, and 0.7% had a fatal stroke at a median age of 71.

Women with a history of infertility were at a 14% higher risk of non-fatal stroke than women without infertility.Miscarriage was also associated with an 11% higher risk of non-fatal stroke compared to women who had not had a miscarriage.

For women who had three or more miscarriages, the increased risk of non-fatal ischaemic and haemorrhagic stroke was 37% and 41% respectively. Similarly, for fatal ischaemic and haemorrhagic stroke, three or more miscarriages were linked to an 83% and 84% risk increase respectively

The researchers therefore concluded that the link between infertility and increased stroke risk may be due to conditions such as polycystic ovary syndrome (PCOS) and premature ovarian insufficiency (POI), while endothelial dysfunction which is usually the narrowing of the heart's blood vessels may explain the increased risk of stroke for women with a history of recurrent stillbirth or miscarriage.

Reference: Chen Liang, PhD candidate, Hsin-Fang Chung,Annette J Dobson, professor, Kunihiko Hayashi, professor, Yvonne T van der Schouw,Diana Kuh,Rebecca Hardy, Carol A Derby, Samar R El Khoudary,Imke Janssen,Sven Sandin,  Elisabete Weiderpass,Gita D Mishra. BMJ 2022; 377 doi: https://doi.org/10.1136/bmj-2022-070603 (Published 22 June 2022)