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PloS One 2020Obesity is a major health problem in low and middle income countries (LMICs) and is associated with miscarriage. This study aims to examine the association between...
BACKGROUND
Obesity is a major health problem in low and middle income countries (LMICs) and is associated with miscarriage. This study aims to examine the association between obesity and miscarriage among reproductive age women (15-49 years) in Nepal.
METHODS
The combined 19160 cross-sectional pregnancy data from the Nepal Demographic and Health Survey (NDHS) for the years 2001, 2006, 2011 and 2016 was utilized. Miscarriage was defined as a spontaneous loss of pregnancy that occurred before the foetus reached 7 months of gestational age. Logistic regression analyses that adjusted for clustering, stratification and sampling weights were used to examine the association between obesity and miscarriage among women of reproductive age.
RESULTS
The odds of miscarriage were 1.45 times higher (Adjusted odds ratio (AOR) = 1.45; 95%Cl: 1.06, 1.98, P = 0.021) among women with obesity. Women who did not use contraception, younger (15-19 years), and older women (35 years or more) were significantly more likely to have miscarriage. Women who smoked tobacco reported higher odds of miscarriage than women who did not smoke tobacco (AOR = 1.27; 95%Cl: 1.07,1.50, P = 0.006). Stratification of maternal smoking status by maternal Body Mass Index (BMI), after adjusting for contraception, mother age and year of survey revealed that tobacco smoking and obesity are associated with miscarriage (AOR = 1.46; 95%Cl: 1.05,2.04, P = 0.025).
CONCLUSIONS
Findings from this study show that obesity and tobacco smoking are associated with miscarriage. Smoking cessation, pregnancy planning and counselling on healthy weight for women of reproductive age in Nepal may help promote healthy behaviours and decrease the likelihood of miscarriage.
Topics: Abortion, Spontaneous; Adult; Cross-Sectional Studies; Female; Health Surveys; Healthy Lifestyle; Humans; Maternal Age; Middle Aged; Nepal; Obesity; Pregnancy; Risk Factors; Tobacco Smoking; Young Adult
PubMed: 32760090
DOI: 10.1371/journal.pone.0236435 -
Paediatric and Perinatal Epidemiology Sep 2020Experiences typically considered private, such as, miscarriages and preterm births are being discussed publicly on social media and Internet discussion websites. These...
BACKGROUND
Experiences typically considered private, such as, miscarriages and preterm births are being discussed publicly on social media and Internet discussion websites. These data can provide timely illustrations of how individuals discuss miscarriages and preterm births, as well as insights into the wellbeing of women who have experienced a miscarriage.
OBJECTIVES
To characterise how users discuss the topic of miscarriage and preterm births on Twitter, analyse trends and drivers, and describe the perceived emotional state of women who have experienced a miscarriage.
METHODS
We obtained 291 443 Twitter postings on miscarriages and preterm births from January 2017 through December 2018. Latent Dirichlet Allocation (LDA) was used to identify major topics of discussion. We applied time series decomposition methods to assess temporal trends and identify major drivers of discussion. Furthermore, four coders labelled the emotional content of 7282 personal miscarriage disclosure tweets into the following non-mutually exclusive categories: grief/sadness/depression, anger, relief, isolation, annoyance, and neutral.
RESULTS
Topics in our data fell into eight groups: celebrity disclosures, Michelle Obama's disclosure, politics, healthcare, preterm births, loss and anxiety, flu vaccine and ectopic pregnancies. Political discussions around miscarriages were largely due to a misunderstanding between abortions and miscarriages. Grief and annoyance were the most commonly expressed emotions within the miscarriage self-disclosures; 50.6% (95% confidence interval [CI] 49.1, 52.2) and 16.2% (95% CI 15.2, 17.3). Postings increased with celebrity disclosures, pharmacists' refusal of prescribed medications and outrage over the high rate of preterm births in the United States. Miscarriage disclosures by celebrities also led to disclosures by women who had similar experiences.
CONCLUSIONS
This study suggests that increase in discussions of miscarriage on social media are associated with several factors, including celebrity disclosures. Additionally, there is a misunderstanding of the potential physical, emotional and psychological impacts on individuals who lose a pregnancy due to a miscarriage.
Topics: Abortion, Spontaneous; Emotions; Famous Persons; Female; Grief; Health Care Costs; Humans; Pregnancy; Premature Birth; Self Disclosure; Social Media; Women's Health
PubMed: 31912544
DOI: 10.1111/ppe.12622 -
Human Reproduction (Oxford, England) Sep 2022Is preconception vitamin D level associated with the risk of miscarriage?
STUDY QUESTION
Is preconception vitamin D level associated with the risk of miscarriage?
SUMMARY ANSWER
Preconception vitamin D levels are not associated with the risk of miscarriage in a population of women conceiving naturally.
WHAT IS KNOWN ALREADY
In humans, low vitamin D has been associated with prolonged menstrual cycles, delayed ovulation and a lower probability of conception. Animal and in vitro data indicate that vitamin D may affect implantation.
STUDY DESIGN, SIZE, DURATION
This prospective time-to-pregnancy study included 362 women who were trying to conceive naturally between 2008 and 2015.
PARTICIPANTS/MATERIALS, SETTING, METHODS
This study included participants who had been trying to conceive naturally for 3 months or less at enrollment and aged 30-44 years. A preconception blood sample was collected and 25-hydroxyvitamin D [25(OH)D] was measured. Women who conceived (N = 362) were at risk of a miscarriage from the day of a reported positive pregnancy test until either a participant-reported pregnancy loss or 20 weeks post day of last menstrual period, whichever came first. Gestational age was defined by ovulation. Time to miscarriage (days) or censoring was modeled using a multivariate Cox proportional hazards model. Multiple imputation was performed for missing covariates and missing day of ovulation.
MAIN RESULTS AND THE ROLE OF CHANCE
The mean age was 33 years (SD: 3.0 years). Mean 25(OH)D was lower among those who reported their race as African-American and those with a higher BMI. After adjustment for age, race, BMI, education, exercise, alcohol and caffeine intake, compared to the referent group (30-<40 ng/ml), the hazard ratio (HR) and 95% CI for those with a low 25(OH)D level (<30 ng/ml) was 1.10 (CI: 0.62, 1.91). Among participants with a higher 25(OH)D level (≥40 ng/ml), the HR was 1.07 (CI: 0.62, 1.84).
LIMITATIONS, REASONS FOR CAUTION
This study was limited by a 25(OH)D measurement at only a single time point. A large percentage of women in this study had sufficient vitamin D levels, which may have limited our power to detect an effect of deficiency. Women in this study were older (30-44 years), and predominantly reported their race as White which may limit generalizability.
WIDER IMPLICATIONS OF THE FINDINGS
The findings of this study do not suggest an association between preconception vitamin D and miscarriage. Future research should focus on women at greater risk for miscarriage or in populations at risk for vitamin D deficiency or on supplementation.
STUDY FUNDING/COMPETING INTEREST(S)
This research was supported in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01ES103333). This research was also supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NIH) under award numbers R00HD079659 and R01HD067683. The authors have no conflicts of interest.
TRIAL REGISTRATION NUMBER
N/A.
Topics: Abortion, Spontaneous; Adult; Caffeine; Child; Female; Humans; Pregnancy; Prospective Studies; Time-to-Pregnancy; Vitamin D
PubMed: 35834313
DOI: 10.1093/humrep/deac155 -
American Family Physician Jul 2011The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the... (Review)
Review
The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the care of their family physician throughout the miscarriage process. Up to 15 percent of recognized pregnancies end in miscarriage, and as many as 80 percent of miscarriages occur in the first trimester, with chromosomal abnormalities as the leading cause. In general, no interventions have been proven to prevent miscarriage; occasionally women can modify their risk factors or receive treatment for relevant medical conditions. Unless products of conception are seen, the diagnosis of miscarriage is made with ultrasonography and, when ultrasonography is not available or is nondiagnostic, with measurement of beta subunit of human chorionic gonadotropin levels. Management options for early pregnancy loss include expectant management, medical management with misoprostol, and uterine aspiration. Expectant management is highly effective for the treatment of incomplete abortion, whereas misoprostol and uterine aspiration are more effective for the management of anembryonic gestation and embryonic demise. Misoprostol in a dose of 800 mcg administered vaginally is effective and well-tolerated. Compared with dilation and curettage in the operating room, uterine aspiration is the preferred procedure for early pregnancy loss; aspiration is equally safe, quicker to perform, more cost-effective, and amenable to use in the primary care setting. All management options are equally safe; thus, patient preference should guide treatment choice.
Topics: Abortifacient Agents, Nonsteroidal; Abortion, Spontaneous; Administration, Intravaginal; Ambulatory Care; Early Diagnosis; Female; Humans; Misoprostol; Practice Guidelines as Topic; Pregnancy; Time Factors; Treatment Outcome; Vacuum Curettage
PubMed: 21766758
DOI: No ID Found -
Blood Jan 2009The antiphospholipid syndrome (APS) is an acquired thrombophilia, characterized by the occurrence of venous and arterial events. This article examines the laboratory and... (Review)
Review
The antiphospholipid syndrome (APS) is an acquired thrombophilia, characterized by the occurrence of venous and arterial events. This article examines the laboratory and key clinical aspects of APS. Particular focus is given to anti-beta 2-glycoprotein I (beta(2)GPI) antibodies in view of their recent inclusion in the APS classification criteria. The clinical utility of using the beta(2)GPI enzyme-linked immunosorbent assay, in conjunction with the established lupus anticoagulant assays and cardiolipin enzyme-linked immunosorbent assay, for diagnosing and risk stratifying patients suspected of having APS is discussed. The relative importance of the various assays in diagnosing obstetric APS (early and late gestation miscarriages) is explored. The implications of recent epidemiologic findings for possibly understanding the underlying pathophysiologic mechanisms of obstetric APS are highlighted. Insights into which patients with obstetric APS may be at most risk of thrombotic complications are presented.
Topics: Abortion, Spontaneous; Antiphospholipid Syndrome; Enzyme-Linked Immunosorbent Assay; Female; Humans; Lupus Coagulation Inhibitor; Male; Pregnancy; Thrombophilia; beta 2-Glycoprotein I
PubMed: 18755986
DOI: 10.1182/blood-2007-12-129627 -
Basic & Clinical Pharmacology &... Apr 2015Corticosteroids are potent anti-inflammatory and immunosuppressive drugs, which sometimes must be given to pregnant women. Corticosteroids have been suspected to be... (Meta-Analysis)
Meta-Analysis Review
Corticosteroids are potent anti-inflammatory and immunosuppressive drugs, which sometimes must be given to pregnant women. Corticosteroids have been suspected to be teratogenic for many years; however, there is conflicting evidence regarding the association. Based on a literature review of three databases, this MiniReview provides an overview of inhaled and oral corticosteroid use in pregnancy with specific emphasis on the association between use of corticosteroids during pregnancy and risk of miscarriage and congenital malformations in offspring. The use of corticosteroids among pregnant women ranged from 0.2% to 10% and increased nearly two times in recent years. Taken together, the evidence suggests that the use of corticosteroids in early pregnancy is not associated with an increased risk of congenital malformations overall or oral clefts in offspring; at the same time, published estimates are inconsistent. The use of inhaled corticosteroids was associated with a slightly increased risk of miscarriage, whereas the use of oral corticosteroids was not; however, confounding by indication could not be ruled out.
Topics: Abnormalities, Drug-Induced; Abortion, Spontaneous; Administration, Inhalation; Administration, Oral; Adrenal Cortex Hormones; Adult; Female; Humans; Pregnancy; Risk
PubMed: 25515299
DOI: 10.1111/bcpt.12367 -
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 -
BJOG : An International Journal of... Aug 2022To examine the association between maternal exposure to ciprofloxacin and the risk of miscarriage and major malformations.
OBJECTIVE
To examine the association between maternal exposure to ciprofloxacin and the risk of miscarriage and major malformations.
DESIGN
A nationwide register-based cohort study.
SETTING
Data were obtained from the Medical Birth Registry, the National Hospital Registry, the Danish National Prescription Registry and Statistics Denmark.
POPULATION
Data were collected in the period between 1997 and 2016 and included all registered pregnancies that ended in an elective termination, miscarriage, stillbirth or a live birth. Exposure was defined as redeeming one or more prescriptions of ciprofloxacin.
METHODS
Miscarriage was defined as a diagnosis given before 22 weeks without any medical intervention. Major malformations were classified according to EUROCAT 1.4. We matched ciprofloxacin-exposed pregnancies to unexposed pregnancies on the propensity score in a ratio 1:4. To estimate the hazard ratio (HR) of miscarriage a Cox proportional hazard regression model was used. A log binomial model was used to estimate the relative risk ratio (RR) of major malformations.
MAIN OUTCOME MEASURES
HR of miscarriage and the RR of major malformations.
RESULTS
A total of 1 650 649 pregnancies were identified. Of these, 10 250 (2050 ciprofloxacin-exposed) and 6100 (1220 ciprofloxacin-exposed) were included in the miscarriage and major malformation analysis, respectively. The HR of miscarriage was 0.99 (95% confidence interval [CI] 0.84-1.17). For major malformation, the RR was 1.01 (95% CI 0.72-1.40). For the organ-specific major malformations and the sensitivity analyses, no significant increased risks were identified.
CONCLUSION
We demonstrated no association between miscarriage and maternal ciprofloxacin exposure within the first 22 weeks of pregnancy, or between major malformations and maternal exposure during the first trimester.
TWEETABLE ABSTRACT
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
Topics: Abortion, Spontaneous; Ciprofloxacin; Cohort Studies; Denmark; Female; Humans; Pregnancy; Pregnancy Trimester, First
PubMed: 34954900
DOI: 10.1111/1471-0528.17083 -
Journal of Medicine and Life Jun 2022Miscarriage is the most common complication of pregnancy. Moreover, vitamin D deficiency is a prevalent concern among women of reproductive age, particularly in the Arab...
Miscarriage is the most common complication of pregnancy. Moreover, vitamin D deficiency is a prevalent concern among women of reproductive age, particularly in the Arab world, where the link between vitamin D deficiency and miscarriage is still unknown. This study was conducted to determine the relationship between vitamin D and miscarriage by comparing the concentration of vitamin D among women with spontaneous abortion and pregnant women. A total of 80 subjects were enrolled in this study and divided into two groups. The first group included 40 women with spontaneous abortions aged between 18 and 40 years. The second group included 40 pregnant women without previous history of miscarriages. Total 25-hydroxy vitamin D (25-OH-VD) measurement was estimated with a Dry Fluorescence Immunoassay analyzer using the Lansionbio LS-1100 instrument. The relationship between the five age groups and the vitamin D status of women with spontaneous abortion was not significant (p>0.05). There was no significant relationship between the miscarriage trimesters and vitamin D status (p>0.05) and between the five age groups (p>0.05). In our study, 95% of women with spontaneous abortion had vitamin D deficiency, compared to only 17.5% of pregnant women. A normal range of vitamin D improves the growth of the fetus and prevents pregnancy complications and miscarriage, promoting the growth of blood vessels in the placenta and improving the function of immune cells.
Topics: Abortion, Spontaneous; Adolescent; Adult; Female; Humans; Iraq; Pregnancy; Vitamin D; Vitamin D Deficiency; Vitamins; Young Adult
PubMed: 35928352
DOI: 10.25122/jml-2021-0266 -
BMJ Open Dec 2023This study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and...
OBJECTIVE
This study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and cytogenetic investigations.
DESIGN
A qualitative interview study with a phenomenological approach. Semistructured interviews were conducted using video conferencing software. Two researchers coded the transcripts and developed themes.
SETTING
A National Health Service (NHS) hospital in central England between May 2021 and July 2021, during the COVID-19 pandemic.
PARTICIPANTS
Patients attending a specialist recurrent miscarriage clinic and their partners. This clinic accepts referrals from all over the UK for couples who have suffered two or more miscarriages.
RESULTS
Seventeen participants were interviewed: 14 women and 3 male partners. Six main themes were identified from the data. Three related to the women's lived experience of recurrent miscarriage (emotions in pregnancy, confidence in their bodies, expectations and coping strategies) and three related to the clinical support offered by the NHS service (impact of early pregnancy scanning, effect of the COVID-19 pandemic and cytogenetic investigations).
CONCLUSIONS
Pregnancy following recurrent miscarriage is extremely difficult. Recurrent miscarriage specialist services can provide couples with support and access to early pregnancy scanning, which can make the first trimester of pregnancy manageable. Partners should not be excluded from the clinic as it can result in a feeling of disconnect. Cytogenetic testing of pregnancy tissue can offer couples with recurrent miscarriage closure after pregnancy loss and is a desired investigation.
Topics: Pregnancy; Female; Humans; Male; State Medicine; Pandemics; Abortion, Habitual; Abortion, Spontaneous; Qualitative Research; COVID-19
PubMed: 38123186
DOI: 10.1136/bmjopen-2023-075062