Prevalence and clinical, social, and health care predictors of miscarriage
Abstract 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 objectiv...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-03682-z |
| _version_ | 1818379488872890368 |
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| author | Erin Strumpf Ariella Lang Nichole Austin Shelley A. Derksen James M. Bolton Marni D. Brownell Dan Chateau Patricia Gregory Maureen I. Heaman |
| author_facet | Erin Strumpf Ariella Lang Nichole Austin Shelley A. Derksen James M. Bolton Marni D. Brownell Dan Chateau Patricia Gregory Maureen I. Heaman |
| author_sort | Erin Strumpf |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-14T02:03:35Z |
| format | Article |
| id | doaj.art-194a18125584420ca5f6c9e6094bd712 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-14T02:03:35Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-194a18125584420ca5f6c9e6094bd7122022-12-21T23:20:57ZengBMCBMC Pregnancy and Childbirth1471-23932021-03-012111910.1186/s12884-021-03682-zPrevalence and clinical, social, and health care predictors of miscarriageErin Strumpf0Ariella Lang1Nichole Austin2Shelley A. Derksen3James M. Bolton4Marni D. Brownell5Dan Chateau6Patricia Gregory7Maureen I. Heaman8Department of Epidemiology, Biostatistics, and Occupational Health, McGill University Leacock Building, Room 418School of Nursing, McGill UniversityDepartment of Epidemiology, Biostatistics, and Occupational Health, McGill University Leacock Building, Room 418Manitoba Centre for Health Policy, University of ManitobaManitoba Centre for Health Policy, University of ManitobaManitoba Centre for Health Policy, University of ManitobaManitoba Centre for Health Policy, University of ManitobaDepartment of Nursing, Red River CollegeCollege of Nursing, University of ManitobaAbstract 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.https://doi.org/10.1186/s12884-021-03682-zMiscarriageHealth servicesWomen’s healthManitoba |
| spellingShingle | Erin Strumpf Ariella Lang Nichole Austin Shelley A. Derksen James M. Bolton Marni D. Brownell Dan Chateau Patricia Gregory Maureen I. Heaman Prevalence and clinical, social, and health care predictors of miscarriage BMC Pregnancy and Childbirth Miscarriage Health services Women’s health Manitoba |
| title | Prevalence and clinical, social, and health care predictors of miscarriage |
| title_full | Prevalence and clinical, social, and health care predictors of miscarriage |
| title_fullStr | Prevalence and clinical, social, and health care predictors of miscarriage |
| title_full_unstemmed | Prevalence and clinical, social, and health care predictors of miscarriage |
| title_short | Prevalence and clinical, social, and health care predictors of miscarriage |
| title_sort | prevalence and clinical social and health care predictors of miscarriage |
| topic | Miscarriage Health services Women’s health Manitoba |
| url | https://doi.org/10.1186/s12884-021-03682-z |
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