Risk factors for miscarriage from a prevention perspective: a nationwide follow-up study
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OBJECTIVE: To identify modifiable risk factors for miscarriage and to estimate the preventable proportion of miscarriages that could be attributed to these. DESIGN: Nationwide observational follow-up study. SETTING: Denmark. POPULATION: Ninety-one thousand four hundred and twenty seven pregnancies included in the Danish National Birth Cohort between 1996 and 2002. METHODS: Information on potentially modifiable risk factors before and during pregnancy was collected by means of computer-assisted telephone interviews and linkage with Danish registers, ensuring almost complete follow-up of pregnancy outcome. Modifiable risk factors for miscarriage were identified by multiple Cox regression analysis, which provided the background for our estimations of population attributable fractions. In all, 88,373 pregnancies had full information on all covariates and were included in this analysis. MAIN OUTCOME MEASURES: Miscarriage before 22 completed weeks of gestation. RESULTS: The potentially modifiable pre-pregnant risk factors associated with increased miscarriage risk were: age of 30 years or more at conception, underweight, and obesity. During pregnancy the modifiable risk factors were: alcohol consumption, lifting of >20 kg daily, and night work. We estimated that 25.2% of the miscarriages might be prevented by reduction of all these risk factors to low risk levels. Modification of risk factors acting before and during pregnancy could lead to prevention of 14.7 and 12.5%, respectively, of the miscarriages. Maternal age at conception and alcohol consumption were the most important risk factors. CONCLUSIONS: Miscarriage risk is increased by multiple potentially modifiable risk factors and a considerable proportion of miscarriages may be preventable.
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The literature search identified nine large cohort studies that reported on miscarriage risk in an aggregated total of 4,638,974 pregnancies.
“Our literature search identified nine large cohort studies that reported on miscarriage risk in an aggregated total of 4,638,974 pregnancies (Table 2). 24-31”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [31]
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- Authors
- Feodor Nilsson, S., Andersen, P., Strandberg‐Larsen, K., & Nybo Andersen, A.
- Affiliations
- Section of Social Medicine Department of Public Health Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- University of Copenhagen (DK)
- ORCID
- Strandberg‐Larsen, K
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2014-02-19
- Volume
- 121
- Issue
- 11
- Pages
- 1375-1385
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W1984552508
- Cited by
- 192
- References
- 36
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 14 · 2023: 23 · 2022: 25 · 2021: 28 · 2020: 14 · 2019: 22 · 2018: 11 · 2017: 8 · 2016: 14 · 2015: 6 · 2014: 8
- FWCI
- 5.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- University of Copenhagen (3306045)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- miscarriage, preterm birth, modifiable risk factors, prevention, population attributable fraction, maternal age at conception, prenatal alcohol exposure, obesity, underweight, night work, heavy lifting, pregnancy outcomes
- MeSH terms
- Abortion, Spontaneous, Adult, Alcohol Drinking, Denmark, Female, Follow-Up Studies, Humans, Maternal Age, Middle Aged, Pregnancy, Pregnancy Outcome, Risk Factors, Work Schedule Tolerance, Proportional Hazards Models, Occupational Exposure, Lifting, Sleep Disorders, Circadian Rhythm
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