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Pregnancy Hypertens. 2018 Jan;11:129-135. doi: 10.1016/j.preghy.2017.10.012. Epub 2017 Oct 28.

Assessment of novel cardiovascular biomarkers in women with a history of recurrent miscarriage.

Author information

1
Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: m.m.wagner@lumc.nl.
2
Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
3
Department of Obstetrics and Gynecology, Medical Centre Haaglanden, The Hague, The Netherlands.
4
Department of Clinical Epidemiology and Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands.
5
Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands.
6
Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
7
Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
8
Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands; Division Women and Baby, Department of Obstetrics, Birth Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.

Abstract

OBJECTIVES:

A history of recurrent miscarriage is associated with future cardiovascular disease. The aim of this study was to determine novel cardiovascular biomarkers in women with a history of recurrent miscarriage as this might lead to a better understanding of the association.

STUDY DESIGN:

Women who visited the recurrent miscarriage clinic at Leiden University Medical Centre (between 2000 and 2010), and had three consecutive miscarriages ≤30 years were invited to participate in this follow-up study (between 2012 and 2014). The reference group consisted of women with at least one uncomplicated pregnancy and a history of no miscarriage, matched on zip code, age, and date of pregnancy.

MAIN OUTCOME MEASURES:

Cardiovascular biomarkers were determined, classified into; inflammation (HsCRP, lipoprotein-associated phospholipase A2), thrombosis (homocysteine, folate, anti-cardiolipin antibodies and anti-ß-2-glycoprotein antibodies), lipid metabolism (lipoprotein(a)), renal function (creatinine, microalbuminuria), myocardial damage (N-terminal pro-brain natriuretic peptide, high sensitive TroponineT) and multiple mechanisms (albumin, vitamin D).

RESULTS:

In both groups, 36 women were included. Women with recurrent miscarriage had a significantly higher median HsCRP (1.49 mg/L) compared to women with no miscarriage (1.01 mg/L, p = 0.03) and a significantly lower mean albumin (46.0 vs 47.6g/L, p = 0.004) and vitamin D (55.6 vs 75.4nmol/L, p = 0.007), respectively. Differences remained after adjustments for classic cardiovascular risk factors (BMI, smoking, diabetes mellitus, and hypertension).

CONCLUSIONS:

Our findings suggest a proinflammatory state in women with a history of recurrent miscarriage, which suggests a less optimal health, compared to women with no miscarriage. More research (observational and intervention) is warranted to investigate the association with vitamin D.

KEYWORDS:

Albumin; Cardiovascular biomarkers; HsCRP; Recurrent miscarriage; Vitamin D

PMID:
29102596
DOI:
10.1016/j.preghy.2017.10.012
[Indexed for MEDLINE]

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