Prevalence and clinical, social, and health care predictors of miscarriage.

Autor: Strumpf E; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University Leacock Building, Room 418, 855 Sherbrooke Street West, Montreal, QC, H3A 2T7, Canada. erin.strumpf@mcgill.ca.; Department of Economics, McGill University, Montreal, Canada. erin.strumpf@mcgill.ca., Lang A; School of Nursing, McGill University, Montreal, Canada., Austin N; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University Leacock Building, Room 418, 855 Sherbrooke Street West, Montreal, QC, H3A 2T7, Canada., Derksen SA; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada., Bolton JM; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.; Department of Psychiatry, University of Manitoba, Winnipeg, Canada.; Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada., Brownell MD; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.; Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada., Chateau D; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada., Gregory P; Department of Nursing, Red River College, Winnipeg, Canada., Heaman MI; College of Nursing, University of Manitoba, Winnipeg, Canada.; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Canada.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2021 Mar 05; Vol. 21 (1), pp. 185. Date of Electronic Publication: 2021 Mar 05.
DOI: 10.1186/s12884-021-03682-z
Abstrakt: 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.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje