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Maternal and Child Health Journal Feb 2021To assess university students' knowledge of reproductive health information about miscarriage.
OBJECTIVE
To assess university students' knowledge of reproductive health information about miscarriage.
METHODS
A single-centre, cross-sectional study was carried out using an online survey at a higher education institution in the Republic of Ireland between April and May of 2016. A total of 746 university students' responses were analysed.
RESULTS
Approximately 60% and 70% of college students correctly identified features of first and second trimester miscarriage. After adjusting for confounders, male students were two times more likely to have a poor knowledge of features of miscarriage compared to females (aOR 2.0, 95% CI 1.3-3.0 and aOR 1.7, 95% CI 1.1-2.6 for first and second trimester respectively). Poor knowledge of features of first trimester miscarriage was less common among older students and students who were married, cohabiting or in a relationship (aOR 0.4, 95% CI 0.2-0.6 and aOR 0.4, 95% CI 0.3-0.8 respectively). Students who studied Medicine and Health were more likely to identify any type of treatment for miscarriage compared to students who studied other disciplines. Students who studied Arts and Social Science were more likely to overestimate the percentage of miscarriages with an identified cause compared to students who studied Medicine and Health.
CONCLUSION
Our results provide additional information about the gap of knowledge in regards to reproductive health information about miscarriage, specifically among university students.
Topics: Abortion, Spontaneous; Adult; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Ireland; Male; Pregnancy; Reproductive Health; Students; Surveys and Questionnaires; Universities; Young Adult
PubMed: 33190195
DOI: 10.1007/s10995-020-03017-y -
The Journal of Rheumatology Sep 2015To examine the risk of pregnancy loss in women with rheumatoid arthritis (RA).
OBJECTIVE
To examine the risk of pregnancy loss in women with rheumatoid arthritis (RA).
METHODS
Cumulative numbers of early miscarriages (before gestational Week 12), late miscarriages (weeks 12-22), and stillbirths reported to the Medical Birth Registry of Norway in the period 1999-2009.
RESULTS
There were 1578 women with RA and 411,130 reference women included in the study. Relative risks of early and late miscarriage in women with RA versus references were 1.2 (95% CI 1.1-1.3) and 1.4 (95% CI 1.1-1.7), respectively. There was no difference in stillbirth.
CONCLUSION
The risk of miscarriage was slightly higher among women with RA than in references.
Topics: Abortion, Spontaneous; Adult; Arthritis, Rheumatoid; Female; Gestational Age; Humans; Norway; Pregnancy; Prevalence; Registries; Risk; Stillbirth
PubMed: 26178278
DOI: 10.3899/jrheum.141553 -
Journal of Obstetrics and Gynaecology :... Nov 2009Miscarriage is the most common complication of pregnancy, which creates a significant workload for health-care professionals. For decades, surgical evacuation of the... (Review)
Review
Miscarriage is the most common complication of pregnancy, which creates a significant workload for health-care professionals. For decades, surgical evacuation of the uterus has remained the conventional treatment of first-trimester miscarriage. Recently, non surgical treatments have been introduced with increasing popularity. This review explores the evidence in support of expectant management of first-trimester miscarriage. It is safe, effective and well-tolerated by women. It enhances women's choice and control. It generates significant cost savings compared with the traditional surgical management. Accurate diagnosis, counselling, 24/7 telephone advice and follow-up are among the important aspects of expectant management. More studies are needed to develop methods for identifying miscarriages suitable for expectant management.
Topics: Abortion, Spontaneous; Adult; Choice Behavior; Decision Making; Dilatation and Curettage; Female; Humans; Patient Preference; Patient Selection; Pelvic Infection; Pregnancy; Pregnancy Trimester, First; Risk Assessment
PubMed: 19821656
DOI: 10.3109/01443610903215399 -
Fertility and Sterility Oct 2014To examine whether sperm DNA fragmentation has an effect on pregnancy and miscarriage after IVF and/or intracytoplasmic sperm injection (ICSI). (Meta-Analysis)
Meta-Analysis Review
Whether sperm deoxyribonucleic acid fragmentation has an effect on pregnancy and miscarriage after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis.
OBJECTIVE
To examine whether sperm DNA fragmentation has an effect on pregnancy and miscarriage after IVF and/or intracytoplasmic sperm injection (ICSI).
DESIGN
Systematic review and meta-analysis.
SETTING
University-affiliated teaching hospital.
PATIENT(S)
Infertility patient(s).
INTERVENTION(S)
An exhaustive electronic literature search was conducted on MEDLINE, Google Scholar, and the Cochrane Library, from database inception to October 2013. We included clinical trials that examined the influence of sperm DNA damage on pregnancy and miscarriage of IVF/ICSI.
MAIN OUTCOME MEASURE(S)
The outcomes of interest were pregnancy rate and miscarriage rate.
RESULT(S)
In the analysis of pregnancy, 16 cohort studies (3,106 couples) were included. Of these, 14 studies (2,756 couples, 965 pregnancies) that also mentioned miscarriage were identified in the analysis of miscarriage. Meta-analysis showed that high-level sperm DNA fragmentation has a detrimental effect on outcome of IVF/ICSI, with decreased pregnancy rate and increased miscarriage rate. The stratified analysis by type of procedure (IVF vs. ICSI) indicated that high sperm DNA damage was related to lower pregnancy rates in IVF but not in ICSI cycles, whereas it was associated with higher miscarriage rates in both IVF and ICSI cycles.
CONCLUSION(S)
The results indicate that assays detecting sperm DNA damage should be recommended to those suffering from recurrent failure to achieve pregnancy. Selection of sperm without DNA damage for use may improve the clinical outcome of ART. The data also provide a rationale for conducting further research aimed at evaluating the underlying mechanism(s) responsible for the detrimental effect of high sperm DNA fragmentation and the potential therapy.
Topics: Abortion, Spontaneous; Chi-Square Distribution; DNA Fragmentation; Female; Fertility; Fertilization in Vitro; Humans; Infertility; Male; Odds Ratio; Pregnancy; Pregnancy Rate; Risk Assessment; Risk Factors; Sperm Injections, Intracytoplasmic; Spermatozoa; Treatment Outcome
PubMed: 25190048
DOI: 10.1016/j.fertnstert.2014.06.033 -
BMC Psychiatry Jan 2019Miscarriages are a common pregnancy complication and positive depression screen after a miscarriage has been shown to be high in our population. Various factors are...
INTRODUCTION
Miscarriages are a common pregnancy complication and positive depression screen after a miscarriage has been shown to be high in our population. Various factors are associated with an increased risk of developing depression after a miscarriage. However, these factors vary across populations studied with no studies existing in our region. We set out to determine the factors associated with a positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi.
METHODS
Patients were recruited at the 2 weeks clinic review after a miscarriage in the gynaecological clinics. They were screened using the Edinburgh postnatal depression scale for depression after a miscarriage. Analysis was done using Univariate and multivariate analysis to compare clinical variables between the screen - positive and screen - negative women in order to delineate the potential pattern of association between the two among the study subjects.
RESULTS
Positive depression screen was detected in 34.1% of the patients recruited. Univariate analysis revealed that education level (p = 0.039) and mode of conception (p = 0.005) impacted on the outcome of the depression screen. In multivariate analysis, multiple factors impacted on the depression screen and these included: age (p = 0.009), education level (p = 0.001), gestation at miscarriage (p = 0.04), marital status (p = 0.043), prior miscarriage (p = 0.011) and mode of conception (p = 0.03).
CONCLUSION
Factors that seem to impact on the positive depression screen include a younger age, low education level, an older gestational age at miscarriage, being single, an assisted mode of conception and prior miscarriage. These factors may be used to triage women after a miscarriage in order to pick up those who may screen positive for depression after a miscarriage.
Topics: Abortion, Spontaneous; Adult; Cross-Sectional Studies; Depression; Female; Humans; Kenya; Mass Screening; Pregnancy; Pregnancy Complications; Psychiatric Status Rating Scales
PubMed: 30616554
DOI: 10.1186/s12888-018-1991-5 -
Journal of Human Genetics Jan 2020Miscarriage is the greatest complication of pregnancy, and 70-80% of early miscarriages are mostly due to chromosomal abnormalities in the embryo. There is no evidence...
Miscarriage is the greatest complication of pregnancy, and 70-80% of early miscarriages are mostly due to chromosomal abnormalities in the embryo. There is no evidence that stress is a direct cause of miscarriage. Despite these findings, in a national US survey on the causes of miscarriage, many Americans mistakenly attributed miscarriage to the mental state or behavior of the women. We conducted a survey to assess public attitudes and perceptions regarding the cause and prevalence of miscarriage in Japan. We sent out a questionnaire consisting of 17 questions. The 5000 recipients consisted of men and women (1:1 ratio) aged 18-69 who resided in Aichi Prefecture. A total of 1257 recipients (25%) responded to the questionnaire and 1219 valid respondents (24%) were included in the analyses. Of these, 62% considered a genetic abnormality of the fetus as the cause of miscarriage. Participants who were female, highly educated, married and healthy gave significantly more correct responses. On the other hand, the majority wrongly assumed that a stressful event (65%) and long-standing stress (75%) to be causes of miscarriage. Participants who had no history of miscarriage as well as males answered significantly more incorrectly. Sixty-five percent of respondents thought that miscarriage occurred less than 15% of all pregnancies. Among respondents who had experienced miscarriage personally, 53 and 36% felt guilty and lonely, respectively. Many respondents blamed the woman for the miscarriage either in terms of her behavior or mental stress and considered the frequency of miscarriage to be lower than it actually is.
Topics: Abortion, Spontaneous; Adolescent; Adult; Aged; Attitude; Chromosome Aberrations; Female; Humans; Japan; Male; Middle Aged; Perception; Pregnancy; Prevalence; Surveys and Questionnaires; Young Adult
PubMed: 31761902
DOI: 10.1038/s10038-019-0694-1 -
Urologiia (Moscow, Russia : 1999) Mar 2016In a review article based on the published literature and their own research, the authors examine the role of a man in recurrent miscarriage and reproductive losses in a... (Review)
Review
In a review article based on the published literature and their own research, the authors examine the role of a man in recurrent miscarriage and reproductive losses in a spouse. Detailed description is presented of the negative impact of elevated levels of sperm DNA fragmentation on the course of pregnancy, especially during the first trimester, on the occurrence of recurrent miscarriage or missed abortion, on the effectiveness of assisted reproductive technology (ART) programs. The etiology and pathogenesis of damage to sperm DNA are described. Outlined are positive effects of correcting adverse lifestyle factors, the role of varicocelectomy and antioxidant therapy, and advances in ART. The review specifies the role of different male karyotype abnormalities (translocations) in the pathogenesis of pregnancy loss. The implications of urologic surgery, preimplantation genetic diagnosis in solving this problem are discussed. New treatment strategies using correction of male disorders for couples with recurrent miscarriage are offered.
Topics: Abortion, Spontaneous; Female; Humans; Male; Pregnancy; Sexual Dysfunction, Physiological
PubMed: 28247745
DOI: No ID Found -
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 -
Archives of Gynecology and Obstetrics Aug 2023To evaluate the risk of miscarriage in IVF cycles in women with PCOS. (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate the risk of miscarriage in IVF cycles in women with PCOS.
METHODS
Systematic review and meta-analysis. Systematic search of MEDLINE, EMBASE and Google Scholar. The language search was restricted to English, Spanish and French, from 2000 to 2019, with crosschecking of references from relevant articles. Inclusion criteria were: (1) IVF cycles (2) a group of patients with PCOS was considered separately, (3) the miscarriage rate was reported, (4) there was a control group, (5) definition of PCOS according the Rotterdam criteria. Exclusion criteria were been excluded from the meta-analysis: (1) publication prior to the year 2000, (2) animal studies, (3) reviews, (4) abstracts or conference papers, (5) letters, (6) case reports, (7) studies comparing different IVF techniques, (8) studies comparing groups with and without metformin or other treatments, (9) studies on induced abortions. Risk of bias was assessed by the Newcastle-Ottawa score (NOS). All the included studies had a low risk of bias (NOS scores ranging 7-8). The review protocol was registered in PROSPERO (CRD42020186713). Seventeen studies were included in the meta-analysis. There was a total of 10,472 pregnancies (2650 in PCOS and 7822 in controls) of which 1885 were miscarriages (682 in PCOS and 1203 in controls). We considered the miscarriage rate (MR), preclinical MR, early MR, and late MR.
RESULTS
In IVF pregnancies the risk of miscarriage was significantly increased when considering miscarriages in total (RR = 1.59; CI = 1.45-1.75), preclinical miscarriages (RR = 1.59; CI = 1.35-1.88), and early miscarriages (RR = 1.44; CI = 1.16-1.79). The increased miscarriage rate persisted in Chinese and Western populations when considered separately. The risk of miscarriage was increased in the subgroup of fresh transfers (RR = 1.21; CI = 1.06-1.39) as well as in the subgroup including either fresh or frozen transfers (RR = 1.95; CI = 1.72-2.22).
CONCLUSION
PCOS is linked to an increased MR in IVF pregnancies both of miscarriages in total, and to an increase in preclinical and early miscarriages.
PROSPERO NUMBER
CRD42020186713.
Topics: Female; Humans; Pregnancy; Abortion, Spontaneous; Fertilization in Vitro; Metformin; Polycystic Ovary Syndrome; Pregnancy Rate
PubMed: 36058943
DOI: 10.1007/s00404-022-06757-0 -
Fertility and Sterility Jan 2021To compare short-term fertility rates after medical and surgical management of early miscarriage. (Observational Study)
Observational Study
OBJECTIVE
To compare short-term fertility rates after medical and surgical management of early miscarriage.
DESIGN
Observational cohort study.
SETTING
Academic tertiary-care medical center.
PATIENT(S)
A total of 203 patients were enrolled between June 2017 and May 2018, comprising 106 surgical evacuations and 97 medical evacuations.
INTERVENTION(S)
Either surgical or medical evacuation of the uterine cavity.
MAIN OUTCOME MEASURE(S)
Conception rates 6 months after miscarriage.
RESULT(S)
Conception rates 6 months after miscarriage among women who had attempted to become pregnant were similar between the medically and surgically evacuated groups (68.0% vs. 65.1%). There were no significant differences in background characteristics between the groups, apart from younger age and earlier gestational age among the medically treated group. There was no difference in the proportion of women using assisted reproductive technologies between the medically and surgically managed groups (15.5% vs. 12.6%, respectively). The median time-to-conception was 4 ± 2 months in both groups. Cumulative pregnancy rate 12 months after pregnancy loss, live birth rate, and repeat miscarriage rate also were similar between groups.
CONCLUSION(S)
Modality of uterine evacuation after early miscarriage does not affect short-term fertility outcomes.
Topics: Abortion, Spontaneous; Adolescent; Adult; Cohort Studies; Dilatation and Curettage; Female; Fertility; Humans; Infant, Newborn; Israel; Pregnancy; Pregnancy Rate; Treatment Outcome; Young Adult
PubMed: 32811672
DOI: 10.1016/j.fertnstert.2020.07.016