You know me... or at least some of you do. Always whining and crying over the spilt milk that was my seeming inability to keep a fetus intact for more than a trimester. And if there's one thing I learned (and yes, there was a lot more than one) from my experience of recurrent miscarriage, it was that everyone has a compassion limit. Even the people who love you the most in the whole universe actually do get kind of sick of hearing about your troubles when they happen over and over and over and over. It's okay, really, I'm over it, too -- their being over it, I mean.
Apparently, though, I will never be over the experience of what felt like an endless cycle of hope-and-loss. I don't feel the sadness (hardly ever), but my eye is still drawn perpetually to the most oblique references to miscarriage and pregnancy loss. Most of the time, it's not so much that I'm really interested in knowing the details of these research studies and media claims. It's more a sort of OCD checking-in out of a macabre (or not, depending on your perspectives on death) sense of loyalty to the population of people who've lost children during pregnancy. It goes like this: I'm subscribed to a jillion media sources who bombard me with all manner of subject lines. If the words "miscarriage" or "pregnancy loss" or similar are in the line, I can feel my pupils widen. Whether or not I actually open the mail and look at it, well, that depends on too many things to list here. Suffice to say, I usually don't.
Today, I did. Because today's news is disturbing to me on a present-day basis.
A large study cohort study in Heidelberg (the EPIC, European Prospective Investigation into Cancer and Nutrition) has teased out this tidbit that made my heart race: "women who experience spontaneous pregnancy loss are at a substantially higher risk of MI later in life."
And they mean substantially. From their huge database the researchers gleaned 2876 participants who'd had at least one miscarriage, 2053 who'd had at least one abortion, and 209 who'd had at least one stillbirth. At follow-up through 11 years, 82 cases of MI (myocardial infarction aka 'heart attack') and 112 cases of stroke were confirmed by records within this group of women.
Okay, here's the part where I thought I might just have my own little MI right here at the kitchen table: Recurrent miscarriage (that is, more than 3) was associated with about 9 times the risk of MI.
And yes, the researchers controlled for a lot of factors, including age, smoking, alcohol consumption, body mass index, waist to hip ratio, physical activity, education, number of pregnancies, hypertension, hyperlipidaemia and diabetes mellitus.
:::trying not to hyperventilate here:::
To calm myself down, I recognize that there's not really anything new happening here, it's just science closing in on understanding what already happens. As the study authors say, their findings "have a great deal of biological plausibility" based on what is already believed to be the case with medical conditions that predispose a body to miscarriage and to heart disease. Some good RE's are already on the ball and treating patients for tissue factor (TF), an inflammatory protein that research points to as playing a role in fetal death. This study's authors also postulate about the connections between miscarriage-related infection and cardiovascular disease, endothelial dysfunction and both m/c and MI, and high homocysteine levels' relationship to both, too.
There's a lot of good, thick stuff in this report, published by the British Medical Journal's Heart issue that came out yesterday. The abstract is free, but you need to subscribe to read the details, and they have a 30-day free online trial if you're like me and are too cheap to pay for the journal but too panicked to keep from registering. Even if you're on Internet that's a smidge faster than dial-up and the reg process takes you a good hour. Because you're freaking out now about your ramped up chances at having a heart attack. Like me.
But in the name of responsible journalism, I don't want anyone to think this report says that if you've had multiple miscarriages, you will also have a heart attack. The study does not say that, at all.
I feel better.
I'm going to stop eating cheese and peanut butter so often, I think.
- Elham Kharazmi,
- Laure Dossus,
- Sabine Rohrmann,
- Rudolf Kaaks