{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:24:02Z","timestamp":1791919442164,"version":"4.3.4"},"reference-count":84,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Evidence suggests common pathways between pregnancy losses and subsequent long-term maternal morbidity, rendering pregnancy complications an early chronic disease marker. There is a plethora of studies exploring associations between miscarriage and stillbirth with long-term adverse maternal health; however, these data are inconclusive.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>We systematically searched MEDLINE, EMBASE, AMED, BNI, CINAHL, and the Cochrane Library with relevant keywords and MeSH terms from inception to June 2023 (no language restrictions). We included studies exploring associations between stillbirth or miscarriage and incidence of cardiovascular, malignancy, mental health, other morbidities, and all-cause mortality in women without previous pregnancy loss. Studies reporting short-term morbidity (within a year of loss), case reports, letters, and animal studies were excluded. Study selection and data extraction were performed by 2 independent reviewers. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS) and publication bias with funnel plots. Subgroup analysis explored the effect of recurrent losses on adverse outcomes. Statistical analysis was performed using an inverse variance random effects model and results are reported as risk ratios (RRs) with 95% confidence intervals (CIs) and prediction intervals (PIs) by combining the most adjusted RR, odds ratios (ORs) and hazard ratios (HRs) under the rare outcome assumption. We included 56 observational studies, including 45 in meta-analysis. There were 1,119,815 women who experienced pregnancy loss of whom 951,258 had a miscarriage and 168,557 stillbirth, compared with 11,965,574 women without previous loss. Women with a history of stillbirth had a greater risk of ischaemic heart disease (IHD) RR 1.56, 95% CI [1.30, 1.88]; <jats:italic>p<\/jats:italic> &lt; 0.001, 95% PI [0.49 to 5.15]), cerebrovascular (RR 1.71, 95% CI [1.44, 2.03], <jats:italic>p<\/jats:italic> &lt; 0.001, 95% PI [1.92, 2.42]), and any circulatory\/cardiovascular disease (RR 1.86, 95% CI [1.01, 3.45], <jats:italic>p<\/jats:italic> = 0.05, 95% PI [0.74, 4.10]) compared with women without pregnancy loss. There was no evidence of increased risk of cardiovascular disease (IHD: RR 1.11, 95% CI [0.98, 1.27], 95% PI [0.46, 2.76] or cerebrovascular: RR 1.01, 95% CI [0.85, 1.21]) in women experiencing a miscarriage. Only women with a previous stillbirth were more likely to develop type 2 diabetes mellitus (T2DM) (RR: 1.16, 95% CI [1.07 to 2.26]; <jats:italic>p<\/jats:italic> &lt; 0.001, 95% PI [1.05, 1.35]). Women with a stillbirth history had an increased risk of developing renal morbidities (RR 1.97, 95% CI [1.51, 2.57], <jats:italic>p<\/jats:italic> &lt; 0.001, 95% [1.06, 4.72]) compared with controls. Women with a history of stillbirth had lower risk of breast cancer (RR: 0.80, 95% CI [0.67, 0.96], p-0.02, 95% PI [0.72, 0.93]). There was no evidence of altered risk of other malignancies in women experiencing pregnancy loss compared to controls. There was no evidence of long-term mental illness risk in women with previous pregnancy losses (stillbirth: RR 1.90, 95% CI [0.93, 3.88], 95% PI [0.34, 9.51], miscarriage: RR 1.78, 95% CI [0.88, 3.63], 95% PI [1.13, 4.16]). The main limitations include the potential for confounding due to use of aggregated data with variable degrees of adjustment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our results suggest that women with a history of stillbirth have a greater risk of future cardiovascular disease, T2DM, and renal morbidities. Women experiencing miscarriages, single or multiple, do not seem to have an altered risk.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pmed.1004342","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T18:20:53Z","timestamp":1707502853000},"page":"e1004342","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Fetal loss and long-term maternal morbidity and mortality: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5044-8039","authenticated-orcid":true,"given":"Florentia","family":"Vlachou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2416-7764","authenticated-orcid":true,"given":"Despoina","family":"Iakovou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-2609","authenticated-orcid":true,"given":"Jahnavi","family":"Daru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0428-3039","authenticated-orcid":true,"given":"Rehan","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1608-757X","authenticated-orcid":true,"given":"Litha","family":"Pepas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Quenby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stamatina","family":"Iliodromiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"pmed.1004342.ref001","unstructured":"WHO | Stillbirths. WHO. 2016 [cited 2021 May 6]. http:\/\/www.who.int\/maternal_child_adolescent\/epidemiology\/stillbirth\/en\/."},{"key":"pmed.1004342.ref002","unstructured":"What is Stillbirth? | CDC. [cited 2023 Jun 19]. https:\/\/www.cdc.gov\/ncbddd\/stillbirth\/facts.html."},{"key":"pmed.1004342.ref003","unstructured":"Morin F, Chalmers B, Ciofani L, DeMontigny F, Gower S, Hanvey L, et al. Chapter 7: Loss and grief. In: Family-centred maternity and newborn care: National guidelines [Internet]. 2020 [cited 2023 Jun 19] p. 12. https:\/\/www.canada.ca\/en\/public-health\/services\/maternity-newborn-care-guidelines.html."},{"key":"pmed.1004342.ref004","unstructured":"Late Intrauterine Fetal Death and Stillbirth (Green-top Guideline No. 55). [cited 2021 May 6]. https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg55\/."},{"key":"pmed.1004342.ref005","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1016\/S0140-6736(21)00682-6","article-title":"Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss","volume":"397","author":"S Quenby","year":"2021","journal-title":"Lancet"},{"key":"pmed.1004342.ref006","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s10552-015-0536-1","article-title":"Association between abortion and breast cancer: an updated systematic review and meta-analysis based on prospective studies","volume":"26","author":"J Guo","year":"2015","journal-title":"Cancer Causes Control"},{"key":"pmed.1004342.ref007","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-011864","article-title":"Post-traumatic stress anxiety and depression following miscarriage or ectopic pregnancy: A prospective cohort study","volume":"6","author":"J Farren","year":"2016","journal-title":"BMJ Open"},{"key":"pmed.1004342.ref008","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/bjh.14043","article-title":"Pregnancy loss and risk of ischaemic stroke and myocardial infarction","volume":"174","author":"A Maino","year":"2016","journal-title":"Br J Haematol"},{"key":"pmed.1004342.ref009","doi-asserted-by":"crossref","first-page":"427.e1","DOI":"10.1016\/j.ajog.2020.02.031","article-title":"Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study","volume":"223","author":"PM Barrett","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"pmed.1004342.ref010","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s10654-019-00582-7","article-title":"Pregnancy, pregnancy loss and the risk of diabetes in Chinese women: findings from the China Kadoorie Biobank","volume":"35","author":"SAE Peters","year":"2020","journal-title":"Eur J Epidemiol"},{"key":"pmed.1004342.ref011","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1136\/heartjnl-2012-303237","article-title":"Miscarriage and future maternal cardiovascular disease: A systematic review and meta-analysis","volume":"99","author":"CT Oliver-Williams","year":"2013","journal-title":"Heart"},{"key":"pmed.1004342.ref012","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.12.018","article-title":"Recurrent Pregnancy Loss and Cardiovascular Disease Mortality in Japanese Women: A Population-Based, Prospective Cohort Study","volume":"26","author":"K Yamada","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"pmed.1004342.ref013","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"29","author":"M Page","year":"2021","journal-title":"BMJ"},{"key":"pmed.1004342.ref014","unstructured":"Ottawa Hospital Research Institute. [cited 2021 Nov 2]. http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"pmed.1004342.ref015","first-page":"103","article-title":"The psychological effects of stillbirths on women and their doctors","volume":"16","author":"S. Bourne","year":"1968","journal-title":"J R Coll Gen Pract"},{"key":"pmed.1004342.ref016","doi-asserted-by":"crossref","first-page":"416.e1","DOI":"10.1016\/j.ajog.2014.07.032","article-title":"Is stillbirth associated with long-term atherosclerotic morbidity?","author":"G Pariente","year":"2014","journal-title":"Am J Obstet Gynecol Mosby Inc"},{"key":"pmed.1004342.ref017","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1136\/heartjnl-2015-307563","article-title":"Association between miscarriage and cardiovascular disease in a Scottish cohort","volume":"101","author":"MM Wagner","year":"2015","journal-title":"Heart"},{"key":"pmed.1004342.ref018","article-title":"Pregnancy, pregnancy loss, and the risk of cardiovascular disease in Chinese women: Findings from the China Kadoorie Biobank","volume":"15","author":"SAE Peters","year":"2017","journal-title":"BMC Med"},{"key":"pmed.1004342.ref019","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1007\/s00404-018-4868-4","article-title":"Recurrent pregnancy loss and future risk of female malignancies","volume":"298","author":"R Charach","year":"2018","journal-title":"Arch Gynecol Obstet"},{"key":"pmed.1004342.ref020","doi-asserted-by":"crossref","DOI":"10.1016\/j.jri.2020.103084","article-title":"Maternal history of recurrent pregnancy loss and long-term risk of thromboembolic events","volume":"138","author":"P Schwarzman","year":"2020","journal-title":"J Reprod Immunol"},{"key":"pmed.1004342.ref021","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0261769","article-title":"Long term miscarriage-related hypertension and diabetes mellitus. Evidence from a United Kingdom population-based cohort study","volume":"17","author":"K Okoth","year":"2022","journal-title":"PLoS ONE"},{"key":"pmed.1004342.ref022","doi-asserted-by":"crossref","first-page":"292","DOI":"10.5694\/j.1326-5377.1991.tb142283.x","article-title":"Early parental responses to sudden infant death, stillbirth or neonatal death","volume":"155","author":"JC Vance","year":"1991","journal-title":"Med J Aust"},{"key":"pmed.1004342.ref023","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1136\/bmj.312.7045.1505","article-title":"Psychological complications after stillbirth\u2014influence of memories and immediate management: Population based study","volume":"312","author":"I Radestad","year":"1996","journal-title":"BMJ"},{"key":"pmed.1004342.ref024","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1136\/bmj.326.7386.423","article-title":"Spontaneous loss of early pregnancy and risk of ischaemic heart disease in later life: retrospective cohort study","volume":"326","author":"GCS Smith","year":"2003","journal-title":"BMJ"},{"key":"pmed.1004342.ref025","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/aje\/kwh064","article-title":"Pregnancy Complications and Subsequent Maternal Cerebrovascular Events: A Retrospective Cohort Study of 119,668 Births","volume":"159","author":"JP Pell","year":"2004","journal-title":"Am J Epidemiol"},{"key":"pmed.1004342.ref026","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3109\/00016340903380758","article-title":"Miscarriage and risk of cardiovascular disease","volume":"89","author":"E Kharazmi","year":"2010","journal-title":"Acta Obstet Gynecol Scand"},{"key":"pmed.1004342.ref027","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1093\/eurpub\/cks107","article-title":"Reproductive history patterns and long-term mortality rates: A Danish, population-based record linkage study","volume":"23","author":"PK Coleman","year":"2013","journal-title":"Eur J Public Health"},{"key":"pmed.1004342.ref028","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1161\/CIRCULATIONAHA.112.000285","article-title":"Pregnancy loss and later risk of Atherosclerotic disease","volume":"127","author":"MF Ranthe","year":"2013","journal-title":"Circulation"},{"key":"pmed.1004342.ref029","doi-asserted-by":"crossref","first-page":"414.e1","DOI":"10.1016\/j.ajog.2014.05.050","article-title":"Recurrent pregnancy loss: a risk factor for long-term maternal atherosclerotic morbidity?","volume":"211","author":"R Kessous","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"pmed.1004342.ref030","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10654-012-9683-9","article-title":"Does pregnancy or pregnancy loss increase later maternal risk of diabetes?","volume":"27","author":"E Kharazmi","year":"2012","journal-title":"Eur J Epidemiol"},{"key":"pmed.1004342.ref031","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1370\/afm.1668","article-title":"Risk of cardiovascular disease among postmenopausal women with prior pregnancy loss: The women\u2019s health initiative","volume":"12","author":"DR Parker","year":"2014","journal-title":"Ann Fam Med"},{"key":"pmed.1004342.ref032","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1111\/1471-0528.13268","article-title":"Mortality in mothers after perinatal loss: A population-based follow-up study","volume":"123","author":"D Hvidtj\u00f8rn","year":"2015","journal-title":"BJOG"},{"key":"pmed.1004342.ref033","article-title":"Recurrent pregnancy loss is not associated with an increased breast cancer risk","volume":"31","author":"C Lambalk","year":"2016","journal-title":"Abstr 32nd Annu Meet ESHRE"},{"key":"pmed.1004342.ref034","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/1471-0528.15452","article-title":"Early or late pregnancy loss and development of clinical cardiovascular disease risk factors: a prospective cohort study","volume":"126","author":"J Horn","year":"2019","journal-title":"BJOG"},{"key":"pmed.1004342.ref035","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ejogrb.2021.10.033","article-title":"Premature mortality after pregnancy loss: Trends at 1, 5, 10 years, and beyond","volume":"267","author":"N Auger","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"pmed.1004342.ref036","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/0277-9536(96)00039-1","article-title":"The mental health impact of stillbirth, neonatal death or sids: Prevalence and patterns of distress among mothers","volume":"43","author":"FM Boyle","year":"1996","journal-title":"Soc Sci Med"},{"key":"pmed.1004342.ref037","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/humrep\/12.5.1106","article-title":"Spontaneous abortion and psychosomatics. A prospective study on the impact of psychological factors as a cause for recurrent spontaneous abortion","volume":"12","author":"A Bergant","year":"1997","journal-title":"Hum Reprod"},{"key":"pmed.1004342.ref038","first-page":"9","article-title":"A study on Stress, Depression and NK Cytotoxic Potential in Women with Recurrent Spontaneous Abortion","volume":"5","author":"A Andalib","year":"2006","journal-title":"Iran J Allergy Asthma Immunol"},{"key":"pmed.1004342.ref039","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1176\/ajp.153.2.226","article-title":"Controlled prospective study on the mental health of women following pregnancy loss","volume":"153","author":"HJEM Janssen","year":"1996","journal-title":"Am J Psychiatry"},{"key":"pmed.1004342.ref040","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1097\/01.AOG.0000264548.10767.ea","article-title":"Late stillbirths and long-term mortality of mothers","volume":"109","author":"R Calderon-Margalit","year":"2007","journal-title":"Obstet Gynecol"},{"key":"pmed.1004342.ref041","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1093\/ije\/dyr134","article-title":"Reproductive history and mortality from cardiovascular disease among women textile workers in Shanghai, China","volume":"40","author":"LG Gallagher","year":"2011","journal-title":"Int J Epidemiol"},{"key":"pmed.1004342.ref042","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1136\/hrt.2010.202226","article-title":"Pregnancy loss and risk of cardiovascular disease: A prospective population-based cohort study (EPIC-Heidelberg)","volume":"97","author":"E Kharazmi","year":"2011","journal-title":"Heart"},{"key":"pmed.1004342.ref043","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0037141","article-title":"Multiple miscarriages are associated with the risk of ovarian cancer: results from the European Prospective Investigation into Cancer and Nutrition","volume":"7","author":"M Braem","year":"2012","journal-title":"PLoS ONE"},{"key":"pmed.1004342.ref044","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/0021-9681(58)90085-7","article-title":"Occurrence of pregnancy, abortion, and artificial menopause among women with coronary artery disease: A preliminary study","volume":"7","author":"W Winkelstein","year":"1958","journal-title":"J Chronic Dis"},{"key":"pmed.1004342.ref045","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1038\/bjc.1994.261","article-title":"Role of reproductive factors in breast cancer in a low-risk area: A case\u2014control study","volume":"70","author":"DN Rao","year":"1994","journal-title":"Br J Cancer"},{"key":"pmed.1004342.ref046","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1007\/BF00052187","article-title":"Spontaneous abortion and risk of fatal breast cancer in a prospective cohort of United States women","volume":"6","author":"EE Calle","year":"1995","journal-title":"Cancer Causes Control"},{"key":"pmed.1004342.ref047","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/ijc.2910610207","article-title":"Abortion and the risk of breast cancer: A case-control study in greece","volume":"61","author":"L Lipworth","year":"1995","journal-title":"Int J Cancer"},{"key":"pmed.1004342.ref048","first-page":"9","article-title":"Menstrual and Reproductive Risk Factors for Ischemic Heart Disease","volume":"1","author":"G Cooper","year":"1999","journal-title":"Epidemiology"},{"key":"pmed.1004342.ref049","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1136\/jech.55.5.336","article-title":"Abortion and breast cancer: a case-control record linkage study","volume":"55","author":"MJ Goldacre","year":"2001","journal-title":"J Epidemiol Community Health"},{"key":"pmed.1004342.ref050","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1002\/ijc.10877","article-title":"Abortions and breast cancer: record-based case-control study","volume":"103","author":"G Erlandsson","year":"2003","journal-title":"Int J Cancer"},{"key":"pmed.1004342.ref051","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/ijc.11598","article-title":"Menstrual and reproductive factors and endometrial cancer risk: Results from a population-based case-control study in urban Shanghai","volume":"108","author":"WH Xu","year":"2004","journal-title":"Int J Cancer"},{"key":"pmed.1004342.ref052","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1136\/jech.2004.026393","article-title":"Risk of breast cancer after miscarriage or induced abortion: a Scottish record linkage case-control study","volume":"59","author":"D Brewster","year":"2005","journal-title":"J Epidemiol Community Health"},{"key":"pmed.1004342.ref053","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1002\/ijc.22001","article-title":"Breast cancer risk in relation to abortion: Results from the EPIC study","volume":"119","author":"GK Reeves","year":"2006","journal-title":"Int J Cancer"},{"key":"pmed.1004342.ref054","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ejogrb.2007.01.005","article-title":"Menstrual and reproductive factors and risk of non-fatal acute myocardial infarction in Italy","volume":"134","author":"P Bertuccio","year":"2007","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"pmed.1004342.ref055","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/0002-8703(64)90094-8","article-title":"Age trend of mortality from coronary artery disease in women and observations on the reproductive patterns of those affected","volume":"67","author":"W Winkelstein","year":"1964","journal-title":"Am Heart J"},{"key":"pmed.1004342.ref056","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1007\/s10552-009-9402-3","article-title":"Incomplete pregnancy and risk of ovarian cancer: results from two Australian case\u2013control studies and systematic review","volume":"20","author":"M-LB Dick","year":"2009","journal-title":"Cancer Causes Control"},{"key":"pmed.1004342.ref057","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-12-43","article-title":"Long-term impact of intrauterine fetal death on quality of life and depression: A case-control study","volume":"12","author":"IK Gravensteen","year":"2012","journal-title":"BMC Pregnancy Childbirth"},{"key":"pmed.1004342.ref058","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/ppe.12176","article-title":"The association of stillbirth with depressive symptoms 6\u201336 months post-delivery","volume":"29","author":"CJR Hogue","year":"2015","journal-title":"Paediatr Perinat Epidemiol"},{"key":"pmed.1004342.ref059","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.eclinm.2019.08.017","article-title":"Pregnancy Loss and Cancer Risk: A Nationwide Observational Study","volume":"15","author":"AP Mikkelsen","year":"2019","journal-title":"EClinicalMedicine"},{"key":"pmed.1004342.ref060","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1007\/s00125-020-05154-z","article-title":"Pregnancy loss is associated with type 2 diabetes: a nationwide case-control study","volume":"63","author":"P Egerup","year":"2020","journal-title":"Diabetologia"},{"key":"pmed.1004342.ref061","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1038\/bjc.1983.128","article-title":"Reproductive factors in the aetiology of breast cancer","volume":"47","author":"LA Brinton","year":"1983","journal-title":"Br J Cancer"},{"key":"pmed.1004342.ref062","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/ije\/16.3.347","article-title":"General epidemiology of breast cancer in Northern Italy","volume":"16","author":"C La Vecchia","year":"1987","journal-title":"Int J Epidemiol"},{"key":"pmed.1004342.ref063","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/S0002-9378(87)80271-5","article-title":"Menstrual and reproductive factors and the risk of myocardial infarction in women under fifty-five years of age","volume":"157","author":"C La Vecchia","year":"1987","journal-title":"Am J Obstet Gynecol"},{"key":"pmed.1004342.ref064","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1093\/oxfordjournals.aje.a114901","article-title":"Breast cancer in relation to the occurrence and time of induced and spontaneous abortion","volume":"127","author":"L Rosenberg","year":"1988","journal-title":"Am J Epidemiol"},{"key":"pmed.1004342.ref065","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1038\/bjc.1990.242","article-title":"Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway","volume":"62","author":"H Adami","year":"1990","journal-title":"Br J 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emotional stress is highly prevalent among women with recurrent pregnancy loss","volume":"30","author":"AM Kolte","year":"2015","journal-title":"Hum Reprod"},{"key":"pmed.1004342.ref070","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1161\/CIRCULATIONAHA.118.036748","article-title":"Cardiovascular Disease-Related Morbidity and Mortality in Women with a History of Pregnancy Complications: Systematic Review and Meta-Analysis","author":"SM Grandi","year":"2019","journal-title":"Circulation"},{"key":"pmed.1004342.ref071","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.2337\/diacare.28.5.1113","article-title":"Elevated pregnancy losses at high and low extremes of maternal glucose in early normal and diabetic pregnancy: Evidence for a protective adaptation in diabetes","volume":"28","author":"L Jovanovic","year":"2005","journal-title":"Diabetes Care"},{"key":"pmed.1004342.ref072","doi-asserted-by":"crossref","DOI":"10.1186\/1756-0500-5-133","article-title":"The 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study","volume":"41","author":"IM Engelhard","year":"2003","journal-title":"Behav Res Ther"},{"key":"pmed.1004342.ref079","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/j.0730-7659.2004.00292.x","article-title":"Anxiety after miscarriage: A review of the empirical literature and implications for clinical practice","author":"N. 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