Open AccessLong-Term Mortality in Women With Pregnancy Loss and Modification by Race/Ethnicity
Author(s) -
Sonia M. Grandi,
Stefanie Hinkle,
Sunni Mumford,
Lindsey A. Sjaarda,
Katherine L. Grantz,
Pauline Mendola,
James L. Mills,
Anna Z. Pollack,
Edwina Yeung,
Cuilin Zhang,
Enrique F. Schisterman
Publication year - 2022
Publication title -
american journal of epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.33
H-Index - 256
eISSN - 1476-6256
pISSN - 0002-9262
DOI - 10.1093/aje/kwac023
Subject(s) - medicine , pregnancy , obstetrics , confidence interval , ethnic group , demography , maternal death , cohort study , absolute risk reduction , ectopic pregnancy , gynecology , population , environmental health , genetics , sociology , anthropology , biology
Pregnancy loss is a common reproductive complication, but its association with long-term mortality and whether this varies by maternal race/ethnicity is not well understood. Data from a racially diverse cohort of pregnant women enrolled in the Collaborative Perinatal Project (CPP) from 1959 to 1966 were used for this study. CPP records were linked to the National Death Index and the Social Security Death Master File to identify deaths and underlying cause (until 2016). Pregnancy loss comprised self-reported losses, including abortions, stillbirths, and ectopic pregnancies. Among 48,188 women (46.0% White, 45.8% Black, 8.2% other race/ethnicity), 25.6% reported at least 1 pregnancy loss and 39% died. Pregnancy loss was associated with a higher absolute risk of all-cause mortality (risk difference, 4.0 per 100 women, 95% confidence interval: 1.4, 6.5) and cardiovascular mortality (risk difference, 2.2 per 100 women, 95% confidence interval: 0.8, 3.5). Stratified by race/ethnicity, a higher risk of mortality persisted in White, but not Black, women. Women with recurrent losses are at increased risk of death, both overall and across all race/ethnicity groups. Pregnancy loss is associated with death; however, it does not confer an excess risk above the observed baseline risk in Black women. These findings support the need to assess reproductive history as part of routine screening in women.