Adverse pregnancy and perinatal outcome in patients with recurrent pregnancy loss: multiple imputation analyses with propensity score adjustment applied to a large-scale birth cohort of the Japan Environment and Children's Study
Open accessAbstract
PROBLEM: Several studies have reported the increased risk of preterm birth, premature rupture of membranes, and low birth weight in patients with recurrent pregnancy loss (RPL). There have been a limited number of large population-based studies examining adverse pregnancy and perinatal outcome after RPL. Multiple-imputed analyses (MIA) adjusting for biases due to missing data is also lacking. METHOD OF STUDY: A nationwide birth cohort study known as the "Japan Environment and Children's Study (JECS)" was conducted by the Ministry of the Environment. The subjects consisted of 104 102 registered children (including fetuses or embryos). RESULTS: No increased risk of a congenital anomaly, aneuploidy, neonatal asphyxia, or a small for date infant was observed among the children from women with a history of RPL. A novel increased risk of placental adhesion and uterine infection was found. The adjusted ORs using MIA in women with three or more PL were 1.76 (95% CI, 1.04-2.96) for a stillbirth, 1.68 (1.12-2.52) for a pregnancy loss, 2.53 (1.17-5.47) for placental adhesion, 1.87 (1.37-2.55) and 1.60 (.99-2.57) for mild and severe hypertensive disorders of pregnancy, respectively, 1.94 (1.06-3.55) for uterine infection, 1.28 (1.11-1.47) for caesarean section and .86 (.76-.98) for a male infant. CONCLUSION: MIA better quantified the risk, which could encourage women who might hesitate to attempt a subsequent pregnancy.
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Air pollution is linked to stillbirth, preterm delivery and low birthweight.
“In the context of pregnancy air pollution is linked to stillbirth, preterm delivery and low birthweight. 89,90”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [89]
The Methods section identifies previous pregnancy loss, not air pollution, as the exposure studied. The Results report stillbirth, preterm birth and low birthweight outcomes in relation to pregnancy loss. Searches for air pollution and ambient particulate exposure found no passage linking them to those outcomes in our copy; page numbers were unavailable. (LLM, conf=0.76)
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- Authors
- Sugiura‐Ogasawara, M., Ebara, T., Yamada, Y., Shoji, N., Matsuki, T., Kano, H., Kurihara, T., Omori, T., Tomizawa, M., Miyata, M., Kamijima, M., Saitoh, S., & the Japan Environment, C. S. (. G.
- Affiliations
- Nagoya City University (JP)
- Corresponding author
- Sugiura‐Ogasawara, Mayumi
- ORCID
- Venue
- American Journal of Reproductive Immunology
- Publisher
- Wiley
- Published
- 2018-12-13
- Volume
- 81
- Issue
- 1
- Pages
- e13072-e13072
- ISSN
- 0271-7352 (ISSN-L)
- 1046-7408
- 1600-0897
- PMC
- PMC6646903
- OpenAlex
- W2901935238
- Cited by
- 51
- References
- 29
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 11 · 2023: 9 · 2022: 5 · 2021: 6 · 2020: 5 · 2018: 1
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Reproductive Immunology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Ministry of the Environment
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Keywords
- recurrent pregnancy loss, adverse pregnancy outcomes, perinatal outcomes, placental adhesions, uterine infection, hypertensive disorders of pregnancy, stillbirth, cesarean section, congenital malformations, aneuploidy, neonatal asphyxia, small for gestational age, Japan Environment and Children's Study, multiple imputation, propensity score adjustment, missing data
- MeSH terms
- Abortion, Habitual, Adult, Child, Female, Humans, Infant, Newborn, Japan, Male, Mathematical Computing, Pregnancy, Pregnancy Outcome, Cohort Studies, Propensity Score, Perinatal Death
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