Incidence of early loss of pregnancy
Abstract
We studied the risk of early loss of pregnancy by collecting daily urine specimens from 221 healthy women who were attempting to conceive. Urinary concentrations of human chorionic gonadotropin (hCG) were measured for a total of 707 menstrual cycles with use of an immunoradiometric assay that is able to detect hCG levels as low as 0.01 ng per milliliter, with virtually 100 percent specificity for hCG in the presence of luteinizing hormone. Our criterion for early pregnancy--an hCG level above 0.025 ng per milliliter on three consecutive days--was determined after we compared the hCG levels in the study group with the levels in a comparable group of 28 women who had undergone sterilization by tubal ligation. We identified 198 pregnancies by an increase in the hCG level near the expected time of implantation. Of these, 22 percent ended before pregnancy was detected clinically. Most of these early pregnancy losses would not have been detectable by the less sensitive assays for hCG used in earlier studies. The total rate of pregnancy loss after implantation, including clinically recognized spontaneous abortions, was 31 percent. Most of the 40 women with unrecognized early pregnancy losses had normal fertility, since 95 percent of them subsequently became clinically pregnant within two years.
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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 [68]
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 [68]
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- Authors
- Wilcox, A. J., Weinberg, C. R., O'Connor, J. F., Baird, D. D., Schlatterer, J. P., Canfield, R. E., Armstrong, E. G., & Nisula, B. C.
- Affiliations
- National Institutes of Health (US)
- Columbia University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1988-07-28
- Volume
- 319
- Issue
- 4
- Pages
- 189-194
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2322561651
- Cited by
- 2,354
- References
- 28
- Citations by year
- 2026: 48 · 2025: 87 · 2024: 75 · 2023: 82 · 2022: 101 · 2021: 112 · 2020: 107 · 2019: 91 · 2018: 78 · 2017: 77 · 2016: 94 · 2015: 82 · 2014: 81 · 2013: 93 · 2012: 71
- FWCI
- 15.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Environmental Health Sciences (N01 ES 4-4054)
- National Center for Research Resources (RR 00645)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD-15455)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- early pregnancy loss, miscarriage, human chorionic gonadotropin, urinary hCG, implantation, pregnancy diagnosis, tubal ligation, fertility
- MeSH terms
- Abortion, Spontaneous, Adult, Female, Chorionic Gonadotropin, Humans, Pregnancy, Pregnancy Trimester, First
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