The Times Australia
The Times World News

.

Women are at greater risk of stroke, the more miscarriages or stillbirths they've had

  • Written by Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland
Women are at greater risk of stroke, the more miscarriages or stillbirths they've had

New research[1] shows women who have had a miscarriage or stillbirth, have an increased risk of stroke[2] – when blood can’t get to the brain, because of a blocked or burst artery. That risk increases with each miscarriage or stillbirth.

Trying to establish this link is difficult because it requires following a large number of women over a long period of time and having reliable data on women’s experiences. Our study, published by the British Medical Journal today, is the first to conclusively show the link between pregnancy loss and stroke.

Many women are unaware their experiences during pregnancy can be an early marker of later health dangers. Our findings show their doctors should be alert to their increased risk.

It’s possible infertility, miscarriage, and stillbirth could increase stroke risk because of other health issues. These could include endocrine disorders (low oestrogen or insulin resistance), inflammation, problems with endothelial cells that assist in blood flow, psychological disorders, unhealthy behaviours (such as smoking) or obesity.

Heartbreak then stroke risk

Our research[3] is based on pooled data from 618,851 women who took part in eight separate studies in Australia, China, Japan, Netherlands, Sweden, the United Kingdom and the United States.

The women were aged between 32 and 73 when they were first enrolled in the studies and were followed up for an average of 11 years.

The study showed that over the time they were studied, 9,265 (2.8%) women had at least one non-fatal stroke and 4,003 (0.7%) women had a fatal stroke. Overall, 91,569 (16.2%) women had a history of miscarriage while 24,873 (4.6%) had a history of stillbirth.

Among the women who had ever been pregnant, women who had reported a miscarriage had a 11% higher risk of a non-fatal stroke and 17% higher risk of a fatal stroke compared with women who have not had a miscarriage.

The risk increased with each miscarriage, so that women who had three or more miscarriages had a 35% higher risk for non-fatal stroke (from incidence rate of 43 per 100,000 “person years[4]” to 58 per 100,000) and an 82% higher risk in fatal strokes (from 11.3 per 100,000 person years to 18 per 100,000) compared with women who had never miscarried.

Stillbirth also significantly increased the risk of stroke.

Among women who had ever been pregnant, women who had a history of stillbirth had a 31% higher risk of non-fatal strokes (from an incidence rate of 42 per 100,000 person years to 69.5 per 100,000) and a 7% higher risk of fatal strokes.

Again, the greater the number of stillbirths, the higher the risk of later strokes, with women who had had two or more stillbirths having a 26% higher risk of fatal strokes (rising from 11 per 100,000 person years to 51.1 per 100,000).

The study is the first to show links with stroke subtypes: stillbirths were linked to non-fatal ischaemic (blockage) stroke or fatal haemorrhagic (bleeding) stroke; miscarriages were linked to both subtypes.

Our study strengthens findings from a previous systematic review[5] that found similar results but showed limited evidence linked to stroke subtypes.

Of the possible explanations for these links, problems[6] with endothelial cells (which control vascular relaxation and contraction as well as release blood-clotting enzymes) might lead to pregnancy loss through problems with the placenta. These problems also relate to how blood vessels dilate and get inflamed or blocked during stroke[7].

dice showing F. A. S. T.
Warning signs of a stroke include sudden changes to a person’s face, arm sensations or speech. Shutterstock[8]

Read more: What causes miscarriages? A doctor explains why women shouldn't blame themselves[9]

Adjusting for known risk factors

Our findings were adjusted for many of the known risk factors for stroke: body mass index, whether the women smoked or not, whether they had high blood pressure, or diabetes. The numbers were also adjusted for ethnicity and education level.

By adjusting for risk factors, we can isolate the increased risk likely linked to the number of miscarriages or stillbirths the women.

Read more: Remind me again, why is salt bad for you?[10]

What should women and their doctors do with this information?

When doctors do a heart health check[11], they look at the risk of cardiovascular disease[12] overall – that is, heart disease, heart failure and stroke. By considering these risks, doctors assess and predict the risk of future disease.

The current Australian guidelines[13] recommend heart health checks should be conducted regularly for people aged 45 to 74, or for Aboriginal and Torres Strait Islander peoples from the age of 30 – this is when the risk of cardiovascular disease starts to increase.

The guidelines recommend medication (blood pressure medication and/or lipid-lowering medication such as statins) when the risk of cardiovascular disease is greater than 15% in the next five years.

These guidelines are currently being updated by the Australian Chronic Disease Prevention Alliance[14] (which includes the Cancer Council Australia, Diabetes Australia, Kidney Health Australia, National Heart Foundation of Australia and the Stroke Foundation), but more recent international guidelines recommend medication at lower levels of risk.

doctor checks patient's heartbeat Doctors should be aware and consider women’s pregnancy history in assessing stroke risk. Shutterstock[15]

Read more: I'm approaching a 'milestone' birthday. What health checks should I have at my age?[16]

No matter what your risk of cardiovascular disease is, the best way to prevent having a stroke is by living as healthy a lifestyle as possible: stopping smoking, eating a healthy diet, having a moderate alcohol intake and doing regular exercise.

These lifestyle measures lower risk for everybody, but doctors will try particularly hard to help people do this who are at long term risk.

Our research shows miscarriage and stillbirth are signals a woman is at increased risk of cardiovascular disease. These events occur many years before a woman develops other risk factors, such as high blood pressure, diabetes or high cholesterol.

Women who have experienced a miscarriage or stillbirth should discuss these with their doctor. Knowing you have a higher risk of stroke is opportunity to monitor your health and make lifestyle changes that can help prevent stroke.

GPs need to ask about women’s reproductive histories and be aware of recurrent miscarriage and stillbirths as potential predictors of stroke risk.

References

  1. ^ research (www.bmj.com)
  2. ^ stroke (strokefoundation.org.au)
  3. ^ research (www.bmj.com)
  4. ^ person years (sph.unc.edu)
  5. ^ systematic review (www.ahajournals.org)
  6. ^ problems (academic.oup.com)
  7. ^ during stroke (www.ahajournals.org)
  8. ^ Shutterstock (image.shutterstock.com)
  9. ^ What causes miscarriages? A doctor explains why women shouldn't blame themselves (theconversation.com)
  10. ^ Remind me again, why is salt bad for you? (theconversation.com)
  11. ^ heart health check (www.heartfoundation.org.au)
  12. ^ cardiovascular disease (www.betterhealth.vic.gov.au)
  13. ^ guidelines (informme.org.au)
  14. ^ Australian Chronic Disease Prevention Alliance (www.acdpa.org.au)
  15. ^ Shutterstock (image.shutterstock.com)
  16. ^ I'm approaching a 'milestone' birthday. What health checks should I have at my age? (theconversation.com)

Read more https://theconversation.com/women-are-at-greater-risk-of-stroke-the-more-miscarriages-or-stillbirths-theyve-had-185490

Times Magazine

Headless CMS in Digital Twins and 3D Product Experiences

Image by freepik As the metaverse becomes more advanced and accessible, it's clear that multiple sectors will use digital twins and 3D product experiences to visualize, connect, and streamline efforts better. A digital twin is a virtual replica of ...

The Decline of Hyper-Casual: How Mid-Core Mobile Games Took Over in 2025

In recent years, the mobile gaming landscape has undergone a significant transformation, with mid-core mobile games emerging as the dominant force in app stores by 2025. This shift is underpinned by changing user habits and evolving monetization tr...

Understanding ITIL 4 and PRINCE2 Project Management Synergy

Key Highlights ITIL 4 focuses on IT service management, emphasising continual improvement and value creation through modern digital transformation approaches. PRINCE2 project management supports systematic planning and execution of projects wit...

What AI Adoption Means for the Future of Workplace Risk Management

Image by freepik As industrial operations become more complex and fast-paced, the risks faced by workers and employers alike continue to grow. Traditional safety models—reliant on manual oversight, reactive investigations, and standardised checklist...

From Beach Bops to Alpine Anthems: Your Sonos Survival Guide for a Long Weekend Escape

Alright, fellow adventurers and relaxation enthusiasts! So, you've packed your bags, charged your devices, and mentally prepared for that glorious King's Birthday long weekend. But hold on, are you really ready? Because a true long weekend warrior kn...

Effective Commercial Pest Control Solutions for a Safer Workplace

Keeping a workplace clean, safe, and free from pests is essential for maintaining productivity, protecting employee health, and upholding a company's reputation. Pests pose health risks, can cause structural damage, and can lead to serious legal an...

The Times Features

The Role of Your GP in Creating a Chronic Disease Management Plan That Works

Living with a long-term condition, whether that is diabetes, asthma, arthritis or heart disease, means making hundreds of small decisions every day. You plan your diet against m...

Troubleshooting Flickering Lights: A Comprehensive Guide for Homeowners

Image by rawpixel.com on Freepik Effectively addressing flickering lights in your home is more than just a matter of convenience; it's a pivotal aspect of both home safety and en...

My shins hurt after running. Could it be shin splints?

If you’ve started running for the first time, started again after a break, or your workout is more intense, you might have felt it. A dull, nagging ache down your shins after...

Metal Roof Replacement Cost Per Square Metre in 2025: A Comprehensive Guide for Australian Homeowners

In recent years, the trend of installing metal roofs has surged across Australia. With their reputation for being both robust and visually appealing, it's easy to understand thei...

Why You’re Always Adjusting Your Bra — and What to Do Instead

Image by freepik It starts with a gentle tug, then a subtle shift, and before you know it, you're adjusting your bra again — in the middle of work, at dinner, even on the couch. I...

How to Tell If Your Eyes Are Working Harder Than They Should Be

Image by freepik Most of us take our vision for granted—until it starts to let us down. Whether it's squinting at your phone, rubbing your eyes at the end of the day, or feeling ...