Maternal pre-pregnancy risk factors for miscarriage from a prevention perspective: a cohort study in China

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• 作者：Huan Zhou^a ; ^b ; ^c ; Yongping Liu^a ; Lu Liu^b ; Min Zhang^b ; Xingzhi Chen^b ; ^{chen007835@163.com" class="auth_mail" title="E-mail the corresponding author} ; Yulong Qi^c ; ^{qiyulong@ahedu.gov.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Risk factors ; Cohort study ; Spontaneous abortion ; China
• 刊名：European Journal of Obstetrics & Gynecology and Reproductive Biology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：206
• 期：Complete
• 页码：57-63
• 全文大小：316 K

文摘

To assess the relationship of the pre-pregnancy modifiable risks with miscarriage.

Study design

We randomly selected 51 communities or villages from January 2013 to December 2014 in Anhui, China. We calculated incidence rate ratios (RR) and 95% confidence intervals (CIs) for each risk factor for miscarriage.

Results

The incidence rate of miscarriage was 7.45%, and pre-embryonic loss account for 12.66%, embryonic loss account for 38%, and fetal losses account for 49.34% of all loss. In multivariate analysis, women with hypertension (RR = 2.272, 95% CI = 1.27–4.04), women had a family history of abortion in their mother (RR = 1.96, 95% CI = 1.22–3.14) prior to pregnancy had significantly higher adjusted risk ratio for miscarriage. Obese, overweight, and underweight prior to pregnancy were about 2.01 (95% CI = 1.1–3.68), 1.71 (95% CI = 1.04–2.81), and 2.05 (95% CI = 1.3–3.23) times more likely to end in miscarriage compared with normal weight. Some physical examination indicators, for example pH value of leucorrhea ≥4.5 (RR = 2.13, 95% CI = 1.48–3.07), red blood cell count <5 10(12)/L (RR = 1.52, 95% CI = 1.02–2.26), and positive LgG antibodies to human cytomegalovirus (RR = 1.45, 95% CI = 1.02–3.14) prior to pregnancy had good prediction effect on miscarriage. We also found remarkable differences on risk factors between non-fetal losses and fetal losses.

Conclusions

Our results suggest that these modifiable risks should be included into pre-conception counseling as important risk factors for screening high-risk population and reducing the rate of spontaneous abortion.