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. 2021 Mar 5;21(1):185.
doi: 10.1186/s12884-021-03682-z.

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

Erin Strumpf  1   2 , Ariella Lang  3 , Nichole Austin  4 , Shelley A Derksen  5 , James M Bolton  5   6   7 , Marni D Brownell  5   7 , Dan Chateau  5 , Patricia Gregory  8 , Maureen I Heaman  9   10
Affiliations

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

Erin Strumpf et al. BMC Pregnancy Childbirth. .

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.

Keywords: Health services; Manitoba; Miscarriage; Women’s health.

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Conflict of interest statement

Not applicable

Figures

Fig. 1
Fig. 1
Prevalence of miscarriage, Manitoba (2003–2014)
Fig. 2
Fig. 2
Maternal age at miscarriage or live birth
Fig. 3
Fig. 3
Maternal morbidity (RUB) in the year before the miscarriage or live birth
See this image and copyright information in PMC

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