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Spontaneous loss of early pregnancy and risk of ischaemic heart disease in later life: retrospective cohort study

BMJ 2003; 326 doi: (Published 22 February 2003) Cite this as: BMJ 2003;326:423
  1. Gordon C S Smith, professor (,
  2. Jill P Pell, consultantb,
  3. David Walsh, statisticianc
  1. a Department of Obstetrics and Gynaecology, Cambridge University, Box 223, The Rosie Hospital, Cambridge CB2 2QQ
  2. b Department of Public Health, Greater Glasgow Health Board, Dalian House, Glasgow G3 8YU
  3. c Information and Statistics Division, Common Services Agency, Edinburgh EH5 3SE
  1. Correspondence to: G C S Smith
  • Accepted 12 December 2002

We recently showed that complications in late pregnancy are associated with an increased risk of maternal ischaemic heart disease (IHD) in later life.1 We hypothesised that this may reflect common determinants, such as thrombophilic genetic defects and anticardiolipin antibodies. Spontaneous losses of pregnancy are also associated with inherited and acquired thrombophilias in the mother.2 We examined whether spontaneous losses of early pregnancy are associated with maternal risk of IHD.

Participants, methods, and results

We used routine national maternity data (SMR2) to identify all 129 290 eligible women who delivered their first liveborn infant in Scotland during 1981-5. The exclusion and inclusion criteria, definitions, and demographic characteristics were as previously described.1 We used national death (GRO) and discharge (SMR1) data to determine the risk of death or hospital admission due to IHD during 1981-99. The …

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