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BMC Pregnancy and Childbirth Mar 2021Pregnancy loss is common and several factors (e.g. chromosomal anomalies, parental age) are known to increase the risk of occurrence. However, much existing research...
BACKGROUND
Pregnancy loss is common and several factors (e.g. chromosomal anomalies, parental age) are known to increase the risk of occurrence. However, much existing research focuses on recurrent loss; comparatively little is known about the predictors of a first miscarriage. Our objective was to estimate the population-level prevalence of miscarriages and to assess the contributions of clinical, social, and health care use factors as predictors of the first detected occurrence of these losses.
METHODS
In this population-based cohort study, we used linked administrative health data to estimate annual rates of miscarriage in the Manitoba population from 2003 to 2014, as a share of identified pregnancies. We compared the unadjusted associations between clinical, social, and health care use factors and first detected miscarriage compared with a live birth. We estimated multivariable generalized linear models to assess whether risk factors were associated with first detected miscarriage controlling for other predictors.
RESULTS
We estimated an average annual miscarriage rate of 11.3%. In our final sample (n = 79,978 women), the fully-adjusted model indicated that use of infertility drugs was associated with a 4 percentage point higher risk of miscarriage (95% CI 0.02, 0.06) and a past suicide attempt with a 3 percentage point higher risk (95% CI -0.002, 0.07). Women with high morbidity were twice as likely to experience a miscarriage compared to women with low morbidity (RD = 0.12, 95% CI 0.09, 0.15). Women on income assistance had a 3 percentage point lower risk (95% CI -0.04, -0.02).
CONCLUSIONS
We estimate that 1 in 9 pregnant women in Manitoba experience and seek care for a miscarriage. After adjusting for clinical factors, past health care use and morbidity contribute important additional information about the risk of first detected miscarriage. Social factors may also be informative.
Topics: Abortion, Spontaneous; Adult; Causality; Female; Health Status; Humans; Live Birth; Manitoba; Patient Acceptance of Health Care; Pregnancy; Pregnant Women; Prevalence; Risk Factors; Social Factors; Women's Health
PubMed: 33673832
DOI: 10.1186/s12884-021-03682-z -
Lancet (London, England) Aug 2021
Topics: Abortion, Spontaneous; Female; Humans; Pregnancy
PubMed: 34454667
DOI: 10.1016/S0140-6736(21)01381-7 -
Lancet (London, England) Aug 2021
Topics: Abortion, Spontaneous; Female; Humans; Pregnancy
PubMed: 34454668
DOI: 10.1016/S0140-6736(21)01426-4 -
Gynecologie, Obstetrique, Fertilite &... 2017In spontaneous pregnancies, endometriosis appears to be a risk factor of miscarriage. The aim of this study is to evaluate the association between endometriosis and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
In spontaneous pregnancies, endometriosis appears to be a risk factor of miscarriage. The aim of this study is to evaluate the association between endometriosis and miscarriage in spontaneous pregnancy.
METHODS
We searched the Cochrane Library, Medline of eligible studies from inception to December 2016, without any restriction. We selected studies that compared endometriosis-affected pregnant women to disease-free pregnant women. To ensure the quality of the methodology, the PRISMA criteria have been met at all stages of the development of this meta-analysis. The primary adverse pregnancy outcomes studied was miscarriage. Three reviewers independently extracted the studies' characteristics and outcome data.
RESULTS
Of 225 identified abstracts, 4 primary studies met our inclusion criteria by comparing spontaneous pregnant patients with endometriosis to disease-free women. Miscarriage rate was higher in the endometriosis group (OR 1.77 [CI 95% 1.13-2.78]).
CONCLUSION
In spontaneous pregnancies, endometriosis appears to be a risk factor of miscarriages (almost 80% increased risk). Further prospective studies are needed to confirm these results in order to establish the exact impact of endometriosis on spontaneous pregnancy course.
Topics: Abortion, Spontaneous; Endometriosis; Female; Humans; MEDLINE; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Risk Factors
PubMed: 28712793
DOI: 10.1016/j.gofs.2017.06.003 -
Taiwanese Journal of Obstetrics &... Sep 2020Human papilloma virus (HPV) infection is the most common viral infection of the reproductive tract. HPV infection is more prevalent in pregnant than in age-matched... (Review)
Review
Human papilloma virus (HPV) infection is the most common viral infection of the reproductive tract. HPV infection is more prevalent in pregnant than in age-matched non-pregnant women and its prevalence increases as pregnancy progresses. A number of reports evaluated the role of HPV infection in miscarriages. In the present review, we summarize the existing evidence regarding the association between HPV infection and miscarriage. It is still unclear whether HPV infection is associated with increased risk for miscarriage. Studies in the field yielded conflicting findings and their conclusions are limited by a small sample size and/or methodological limitations. On the other hand, preclinical data support a role of HPV infection in placental dysfunction. Given the high prevalence of HPV infection and the possibility that vaccination against HPV might protect against miscarriage, more studies are needed to elucidate whether this common infection is associated with increased risk for miscarriage.
Topics: Abortion, Spontaneous; Case-Control Studies; Causality; Female; Humans; Incidence; Papillomaviridae; Papillomavirus Infections; Pregnancy; Pregnancy Complications, Infectious
PubMed: 32917313
DOI: 10.1016/j.tjog.2020.07.005 -
JAMA Sep 2020
Topics: Abortion, Spontaneous; Emigrants and Immigrants; Female; Grief; Humans; Pregnancy; Prisons; Texas
PubMed: 32897349
DOI: 10.1001/jama.2020.15959 -
Journal of General Internal Medicine Aug 2020
Topics: Abortion, Induced; Abortion, Spontaneous; Female; Humans; Physicians; Pregnancy; Primary Health Care
PubMed: 32472493
DOI: 10.1007/s11606-020-05919-7 -
Acta Obstetricia Et Gynecologica... Jul 2023According to a precautionary principle, it is recommended that pregnant women and women trying to conceive abstain from alcohol consumption. In this dose-response... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
According to a precautionary principle, it is recommended that pregnant women and women trying to conceive abstain from alcohol consumption. In this dose-response meta-analysis, we aimed to examine the association between alcohol consumption and binge drinking and the risk of miscarriage in the first and second trimesters.
MATERIAL AND METHODS
The literature search was conducted in MEDLINE, Embase and the Cochrane Library in May 2022, without any language, geographic or time limitations. Cohort or case-control studies reporting dose-specific effects adjusting for maternal age and using separate risk assessments for first- and second-trimester miscarriages were included. Study quality was assessed using the Newcastle-Ottawa Scale. This study is registered with PROSPERO, registration number CRD42020221070.
RESULTS
A total of 2124 articles were identified. Five articles met the inclusion criteria. Adjusted data from 153 619 women were included in the first-trimester analysis and data from 458 154 women in the second-trimester analysis. In the first and second trimesters, the risk of miscarriage increased by 7% (odds ratio [OR] 1.07, 95% confidence interval [CI] 0.96-1.20) and 3% (OR 1.03, 95% CI 0.99-1.08) for each additional drink per week, respectively, but not to a statistically significant degree. One article regarding binge drinking and the risk of miscarriage was found, which revealed no association between the variables in either the first or second trimester (OR 0.84 [95% CI 0.62-1.14] and OR 1.04 [95% CI 0.78-1.38]).
CONCLUSIONS
This meta-analysis revealed no dose-dependent association between miscarriage risk and alcohol consumption, but further focused research is recommended. The research gap regarding miscarriage and binge drinking needs further investigation.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Pregnancy Trimester, Second; Binge Drinking; Alcohol Drinking; Maternal Age
PubMed: 37221907
DOI: 10.1111/aogs.14566 -
Lancet (London, England) May 2021The physical and psychological effect of miscarriage is commonly underappreciated. The journey from diagnosis of miscarriage, through clinical management, to supportive...
The physical and psychological effect of miscarriage is commonly underappreciated. The journey from diagnosis of miscarriage, through clinical management, to supportive aftercare can be challenging for women, their partners, and caregivers. Diagnostic challenges can lead to delayed or ineffective care and increased anxiety. Inaccurate diagnosis of a miscarriage can result in the unintended termination of a wanted pregnancy. Uncertainty about the therapeutic effects of interventions can lead to suboptimal care, with variations across facilities and countries. For this Series paper, we have developed recommendations for practice from a literature review, appraisal of guidelines, and expert group discussions. The recommendations are grouped into three categories: (1) diagnosis of miscarriage, (2) prevention of miscarriage in women with early pregnancy bleeding, and (3) management of miscarriage. We recommend that every country reports annual aggregate miscarriage data, similarly to the reporting of stillbirth. Early pregnancy services need to focus on providing an effective ultrasound service, as it is central to the diagnosis of miscarriage, and be able to provide expectant management of miscarriage, medical management with mifepristone and misoprostol, and surgical management with manual vacuum aspiration. Women with the dual risk factors of early pregnancy bleeding and a history of previous miscarriage can be recommended vaginal micronised progesterone to improve the prospects of livebirth. We urge health-care funders and providers to invest in early pregnancy care, with specific focus on training for clinical nurse specialists and doctors to provide comprehensive miscarriage care within the setting of dedicated early pregnancy units.
Topics: Abortion, Spontaneous; Female; Humans; Pregnancy; Pregnancy Complications; Prenatal Care; Ultrasonography
PubMed: 33915095
DOI: 10.1016/S0140-6736(21)00683-8 -
International Journal of Environmental... Jul 2022(1) Background: Miscarriages occur in approximately 15-25% of all pregnancies. There is limited evidence suggesting an association between history of miscarriage and the...
(1) Background: Miscarriages occur in approximately 15-25% of all pregnancies. There is limited evidence suggesting an association between history of miscarriage and the development of diabetic and hypertensive disorders in women. This systematic review aims to collate the existing literature and provide up to date epidemiological evidence on the topic. (2) Methods: We will search CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar, using a combination of medical subject headings, keywords, and search terms, for relevant articles related to the association between miscarriage and the risk of diabetic and hypertensive disorders. Cross-sectional, case-control, nested case-control, case-cohort, and cohort studies published from inception to April 2022 will be included in the search strategy. Three reviewers will independently screen studies and the risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal tool. Where the data permit, a meta-analysis will be conducted. (3) Results: The results of this systematic review will be submitted to a peer-reviewed journal for publication. (4) Conclusions: The findings of this systematic review will instigate efforts to manage and prevent reproductive, cardiovascular, and metabolic health consequences associated with miscarriages.
Topics: Abortion, Spontaneous; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Hypertension, Pregnancy-Induced; Meta-Analysis as Topic; Pregnancy; Research Design; Systematic Reviews as Topic
PubMed: 35886173
DOI: 10.3390/ijerph19148324