02637nas a2200301   4500000000100000008004100001260001700042100001800059700001700077700001400094700001400108700001100122700001500133700001600148700001900164700001600183700001700199700001600216700001500232700001500247700001300262700004700275245013000322300000800452490000700460520185400467022001402321       2017                            d  c1827739441111 aWoodward Mark1 aPeters Sanne1 aYang Ling1 aLi Liming1 aGuo Yu1 aBian Zheng1 aChen Junshi1 aChen Zhengming1 aChen Yiping1 aTian Xiaocao1 aChang Liang1 aZhang Shuo1 aLiu Jiaqiu1 aWang Tao1 aChina Kadoorie Biobank collaboration group00aPregnancy, pregnancy loss, and the risk of cardiovascular disease in Chinese women: findings from the China Kadoorie Biobank.  a1480 v153 a<p>
<b>BACKGROUND: </b>Pregnancy and pregnancy loss may be linked to cardiovascular disease (CVD). However, the evidence is still inconsistent, especially in East Asians, whose reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy, miscarriage, induced abortion, and stillbirth with CVD incidence among Chinese women.
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<b>METHODS: </b>In 2004-2008, the nationwide China Kadoorie Biobank recruited 302,669 women aged 30-79 years from ten diverse localities. During 7&nbsp;years of follow-up, 43,968 incident cases of circulatory disease, 14,440 of coronary heart disease, and 19,925 of stroke (including 11,430 ischaemic and 2170 haemorrhagic strokes), were recorded among 289,573 women without prior CVD at baseline. Cox regression yielded multiple adjusted hazard ratios (HRs) for CVD risks associated with pregnancy outcomes.
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<b>RESULTS: </b>Overall, 99% of women had been pregnant, and among them 10%, 53%, and 7% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Each additional pregnancy was associated with an adjusted HR of 1.03 (95% confidence interval, CI: 1.02; 1.04) for circulatory disease. A history of miscarriage, induced abortion, and stillbirth, respectively, were associated with adjusted HRs of 1.04 (1.01; 1.07), 1.04 (1.02; 1.07), and 1.07 (1.03; 1.11) for circulatory disease. The relationship was stronger with recurrent pregnancy loss; adjusted HRs for each additional loss being 1.04 (1.00; 1.09) for miscarriage, 1.02 (1.01; 1.04) for induced abortion, and 1.04 (1.00; 1.08) for stillbirth.
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<b>CONCLUSIONS: </b>Among Chinese women, increases in pregnancy, and a history and recurrence of miscarriage, induced abortion, and stillbirth are each associated with a higher risk of CVD.
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