Evidence map›Paper›PMID 36330356›Full record

ArticleEuropean heart journal open2022

The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis.

Harry Kyriacou, Abdulrahman Al-Mohammad, Charlotte Muehlschlegel, Lowri Foster-Davies, Maria Eduarda Ferreira Bruco, Chloe Legard, Grace Fisher, Fiona Simmons-Jones, Clare Oliver-Williams

Abstract read
In one paragraph

Article in European heart journal open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Review
  5. Review
  6. Article
  7. Association between multiple complications of pregnancy and risk of cardiovascular disease in a large cohort.International journal of cardiology. Cardiovascular risk and prevention · 2025
    Article
  8. Reproductive-associated risk factors and incident coronary heart disease in women: an umbrella review.American heart journal plus : cardiology research and practice · 2025
    Review
  9. Article
  10. Review
  11. Article
  12. Article
  13. Measuring EQ-5D-5L utility values in parents who have experienced perinatal death.The European journal of health economics : HEPAC : health economics in prevention and care · 2024
    Article
  14. Effects of prior reproductive losses on risk of cardiovascular diseases within six months of a first live birth.International journal of cardiology. Cardiovascular risk and prevention · 2024
    Article
  15. Review
  16. Article
  17. Article
  18. Call for Improved Fourth Trimester Care After Stillbirth.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2024
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Harry KyriacouSchool of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
Abdulrahman Al-MohammadSchool of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
Charlotte MuehlschlegelSchool of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
Lowri Foster-DaviesSchool of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
Maria Eduarda Ferreira BrucoOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.
Chloe LegardOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.
Grace FisherSchool of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK.
Fiona Simmons-JonesHealth Education East of England, 2.4- Vicotria House, Capital Park, Fulbourn, Cambridge, CB21 5XB, UK.
Clare Oliver-WilliamsCardiovascualr Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge Papworth Road, Cambridge Biomedical Campus, Cambridge, CB2 0BB, UK.ORCID https://orcid.org/0000-0002-3573-2426

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Miscarriage and stillbirth have been included in cardiovascular disease (CVD) risk guidelines, however heterogeneity in exposures and outcomes and the absence of reviews assessing induced abortion, prevented comprehensive assessment. We aimed to perform a systematic review and meta-analysis of the risk of cardiovascular diseases for women with prior pregnancy loss (miscarriage, stillbirth, and induced abortion). Methods and results: Observational studies reporting risk of CVD, coronary heart disease (CHD), and stroke in women with pregnancy loss were selected after searching MEDLINE, Scopus, CINAHL, Web of Knowledge, and Cochrane Library (to January 2020). Data were extracted, and study quality were assessed using the Newcastle-Ottawa Scale. Pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated using inverse variance weighted random-effects meta-analysis.Twenty-two studies involving 4 337 683 women were identified. Seven studies were good quality, seven were fair and eight were poor. Recurrent miscarriage was associated with a higher CHD risk (RR = 1.37, 95% CI: 1.12-1.66). One or more stillbirths was associated with a higher CVD (RR = 1.41, 95% CI: 1.09-1.82), CHD (RR = 1.51, 95% CI: 1.04-1.29), and stroke risk (RR = 1.33, 95% CI: 1.03-1.71). Recurrent stillbirth was associated with a higher CHD risk (RR = 1.28, 95% CI: 1.18-1.39). One or more abortions was associated with a higher CVD (RR = 1.04, 95% CI: 1.02-1.07), as was recurrent abortion (RR = 1.09, 95% CI: 1.05-1.13). Conclusion: Women with previous pregnancy loss are at a higher CVD, CHD, and stroke risk. Early identification and risk factor management is recommended. Further research is needed to understand CVD risk after abortion.

Indexed as

AbortionCardiovascular diseaseMiscarriageStillbirthSystematic review

Identifiers

PMID36330356
PMCPMC9617475

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.