Early risk factors for miscarriage: a prospective cohort study in pregnant women
Open accessAbstract
Many pregnancies are lost during early gestation, but clinicians still lack tools to recognize risk factors for miscarriage. Thus, the identification of risk factors for miscarriage during the first trimester in women with no obvious risk for a pregnancy loss was the aim of this prospective cohort trial. A total of 1098 women between gestation weeks 4 and 12 in whom no apparent signs of a threatened pregnancy could be diagnosed were recruited. Demographic, anamnestic, psychometric and biological data were documented at recruitment and pregnancy outcomes were registered subsequently. Among the cases with sufficiently available data, 809 successfully progressing pregnancies and 55 subsequent miscarriages were reported. In this cohort, risk of miscarriage was significantly increased in women at higher age (>33 years), lower body mass index (< or =20 kg/ m(2)) and lower serum progesterone concentrations (< or =12 ng/ml) prior to the onset of the miscarriage. Women with subsequent miscarriage also perceived higher levels of stress/demands (supported by higher concentrations of corticotrophin-releasing hormone) and revealed reduced concentrations of progesterone-induced blocking factor. These risk factors were even more pronounced in the subcohort of women (n = 335) recruited between gestation weeks 4 and 7. The identification of these risk factors and development of an interaction model of these factors, as introduced in this article, will help clinicians to recognize pregnant women who require extra monitoring and who might benefit from therapeutic interventions such as progestogen supplementation, especially during the first weeks of pregnancy, to prevent a miscarriage.
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High alcohol consumption during the first trimester is associated with an increase in miscarriage risk (aOR 1.67; 95% CI 1.31-2.19).
“Our literature review found that alcohol use is also an important modifiable risk factor, as high alcohol consumption during the first trimester is associated with an increase in miscarriage risk (aOR 1·67; 95% CI 1·31-2·19; Table 6). 25,39,62-70”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [69]
Alcohol use is an important modifiable risk factor for miscarriage.
“Our literature review found that alcohol use is also an important modifiable risk factor, as high alcohol consumption during the first trimester is associated with an increase in miscarriage risk (aOR 1·67; 95% CI 1·31-2·19; Table 6). 25,39,62-70”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [69]
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- Authors
- Arck, P. C., Rücke, M., Rose, M., Szekeres-Bartho, J., Douglas, A. J., Pritsch, M., Blois, S. M., Pincus, M. K., Bärenstrauch, N., Dudenhausen, J. W., Nakamura, K., Sheps, S., & Klapp, B. F.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- University Medical Center Hamburg-Eppendorf (DE)
- University of Edinburgh (GB)
- Heidelberg University (DE)
- Stiftung Charité (DE)
- University of British Columbia (CA)
- Corresponding author
- Arck, Petra C
- Venue
- Reproductive BioMedicine Online
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 17
- Issue
- 1
- Pages
- 101-113
- ISSN
- 1472-6483 (ISSN-L)
- OpenAlex
- W2109989172
- Cited by
- 219
- References
- 63
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 11 · 2023: 10 · 2022: 8 · 2021: 18 · 2020: 19 · 2019: 19 · 2018: 12 · 2017: 15 · 2016: 14 · 2015: 16 · 2014: 14 · 2013: 14 · 2012: 10
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Reproductive BioMedicine Online (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Commission
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- miscarriage, early pregnancy loss, risk factors, maternal age, body mass index, serum progesterone, stress, corticotropin-releasing factor, progesterone-induced blocking factor, pregnancy outcome prediction
- MeSH terms
- Abortion, Spontaneous, Adult, Corticotropin-Releasing Hormone, Female, Humans, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First, Progesterone, Prospective Studies, Risk Factors, Stress, Psychological, Cohort Studies, Body Mass Index, Multivariate Analysis
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