Miscarriages and stillbirths might be a marker for women at higher risk of developing heart disease later in life, an observational study suggested.

The study suggests that physicians should now include stillbirth or miscarriage on their list of items to ask about in screening for cardiovascular disease.

Coronary heart disease risk was 27% higher for women who had a history of stillbirth compared with none (multivariate adjusted odds ratio 1.27, 95% CI 1.07-1.51), Donna R. Parker, ScD, of Memorial Hospital of Rhode Island in Pawtucket, and colleagues found.

That risk was a significant 18% to 19% elevated among women with one or two prior miscarriages compared with none in an analysis of the Women’s Health Initiative (WHI) observational cohort appearing in the July/August issue of the Annals of Family Medicine.

“Women with a history of one or more stillbirths or one or more miscarriages appear to be at increased risk of future cardiovascular disease and should be considered candidates for closer surveillance and/or early intervention,” they urged.

The American Heart Association guidelines already include pregnancy complications as a risk factor for cardiovascular disease in women due to growing evidence for an association, but these don’t address long-term cardiovascular implications of pregnancy loss, the group pointed out.

Physicians should now include stillbirth or miscarriage on their list of items to ask about in screening for cardiovascular disease, argued Roxana Mehran, MD, of Mount Sinai School of Medicine in New York City, who was not involved in the study.

“This is so important because the prevalence of pregnancy loss is increasing as the [average] age of women who are becoming pregnant is increasing,” she told MedPage Today.

Women with a history of pregnancy loss perhaps should be screened earlier, agreed Mehran, the founding and immediate past chair of the Society for Cardiovascular Angiography and Interventions’ Women in Innovations program, working with ob/gyns to promote screening women for cardiovascular risk factors.