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- Title
Prevalence and clinical, social, and health care predictors of miscarriage.
- Authors
Strumpf, Erin; Lang, Ariella; Austin, Nichole; Derksen, Shelley A.; Bolton, James M.; Brownell, Marni D.; Chateau, Dan; Gregory, Patricia; Heaman, Maureen I.
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
MANITOBA; MISCARRIAGE; PREGNANCY complication risk factors; MEDICAL care use; PARENTAL age
- Publication
BMC Pregnancy & Childbirth, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2393
- Publication type
journal article
- DOI
10.1186/s12884-021-03682-z