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. 2023 Mar 8;23(1):153.
doi: 10.1186/s12884-023-05479-8.

Pre-pregnancy complications - associated factors and wellbeing in early pregnancy: a Swedish cohort study

Unnur Gudnadottir  1 , Juan Du  2 , Luisa W Hugerth  2   3 , Lars Engstrand  2 , Ina Schuppe-Koistinen  2   4 , Eva Wiberg Itzel  5 , Emma Fransson  2   6 , Nele Brusselaers  2   7   8
Affiliations

Pre-pregnancy complications - associated factors and wellbeing in early pregnancy: a Swedish cohort study

Unnur Gudnadottir et al. BMC Pregnancy Childbirth. .

Abstract

Background: Many couples experience difficulties to become pregnant or carry a pregnancy to term due to unknown causes. Here we define pre-pregnancy complications as having prior recurrent pregnancy loss, prior late miscarriages, time to pregnancy more than one year, or the use of artificial reproductive technologies. We aim to identify factors associated with pre-pregnancy complications and poor well-being in early pregnancy.

Methods: Online questionnaire data from 5330 unique pregnancies in Sweden were collected from November 2017 - February 2021. Multivariable logistic regression modelling was used to investigate potential risk factors for pre-pregnancy complications and differences in early pregnancy symptoms.

Results: Pre-pregnancy complications were identified in 1142 participants (21%). Risk factors included diagnosed endometriosis, thyroid medication, opioids and other strong pain medication, body mass index > 25 kg/m2 and age over 35 years. Different subgroups of pre-pregnancy complications had unique risk factors. The groups also experienced different pregnancy symptoms in early pregnancy, where women that had experienced recurrent pregnancy loss were at higher risk of depression in their current pregnancy.

Conclusion: We report one of the largest pregnancy cohorts with high frequency of pre-pregnancy complications compared to the Swedish population. Prescribed drug use and body weight were the top potentially modifiable risk factors in all groups. Participants that experienced pre-pregnancy complications also had higher risk of depression and pregnancy problems in early pregnancy.

Keywords: Artificial reproductive technologies; Early pregnancy; Fertility; Late miscarriage; Pre-pregnancy; Pregnancy symptoms; Recurrent pregnancy loss; Subfertility.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Categorization of the cohort as uncomplicated pre-pregnancy and pre-pregnancy complications with subgroups. Generated with BioRender
Fig. 2
Fig. 2
Descriptive statistics of the uncomplicated pre-pregnancy and pre-pregnancy complications group, and its subgroups, where the difference between the highest and lowest subgroup value was over 10%. Complete dataset in Supplementary Table 3
Fig. 3
Fig. 3
Venn diagram of risk factors for the different categories of pre-pregnancy complications, shown with percentage of complicated cases. Overlapping circles show risk factors for multiple groups. Generated with BioRender
Fig. 4
Fig. 4
Forest plot showing odds of a pre-pregnancy complications by underlying comorbidities, with 95% confidence intervals. Not having the specific comorbidity was used as reference. Power of each analysis is indicated by the size of the gray boxes
See this image and copyright information in PMC

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