Is the incidence of recurrent pregnancy loss increasing? A retrospective register-based study in Sweden
Open accessAbstract
INTRODUCTION: The aim of this study was to estimate the incidence of recurrent pregnancy loss (RPL). The prevalence of RPL defined as three or more consecutive miscarriages before gestation week 22, is often stated to be 1%. To our knowledge no study has estimated the incidence of RPL, which might be more informative and clinically relevant than the prevalence. MATERIAL AND METHODS: This retrospective register-based study was conducted from 2003 until 2012 in Sweden with data provided by the Swedish National Board of Health and Welfare. In all, 6852 women were registered with the diagnoses of RPL in the National Patient Register. The incidence of RPL is the number of new women receiving the RPL diagnosis per year in the numerator and population at risk in the denominator. RESULTS: For each year, from 2003 to 2012, the incidence was calculated in two different risk populations: [1] all women aged 18-42 years, and [2] all women registered as being pregnant (deliveries or miscarriages). The average incidence in the study period was 53 per 100 000 (0.05%) in women aged 18-42 years and 650 per 100 000 (0.65%) in women who had achieved pregnancy in the period. The incidence of RPL in the two risk populations increased by 74 and 58%, respectively, during the study period. CONCLUSION: This study suggests that the incidence of RPL increased during the 10-year period studied. Causes can only be speculated upon in this study design, but might be associated with environmental changes, as the increase was fairly rapid.
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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 [25]
The Abstract describes a large Swedish register-based study and reports the incidence of recurrent pregnancy loss among pregnant women, so the paper can be identified as a study of that related risk. It does not report the risk of miscarriage generally. The nine-study count and aggregate pregnancy total describe the citing authors’ own literature search, not a finding attributed to this source. (LLM, conf=0.78)
Experimental — accuracy not yet measuredAlcohol 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 [25]
The Discussion (page not provided) considers possible environmental factors, body mass index and smoking frequency, but does not mention alcohol. Searches for first-trimester alcohol consumption, alcohol as a modifiable risk factor, and the cited odds ratio found no supporting passage in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredHigh caffeine intake might be associated with miscarriage (aOR 1.56; 95% CI 0.98-2.50), although there was statistical uncertainty.
“Our review indicated that high caffeine intake might be associated with miscarriage (aOR 1·56; 95% CI 0.98-2·50; Table 6), although there was statistical uncertainty in the finding. 25,39,71”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [25]
The Abstract reports the incidence of recurrent pregnancy loss in Sweden, and the Discussion considers possible environmental factors without identifying caffeine. Searches for caffeine intake and the stated odds ratio found no passage in our copy addressing the claimed association or its uncertainty; no page numbers were available for the indexed passages. (LLM, conf=0.76)
Experimental — accuracy not yet measuredHigh 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 [25]
The Discussion considers possible explanations for changing recurrent pregnancy-loss incidence but does not assess alcohol consumption. Searches for first-trimester alcohol use and the reported odds ratio found no passage in our copy linking alcohol to miscarriage risk or reporting aOR 1.67 (95% CI 1.31–2.19). (LLM, conf=0.76)
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Self-citation
- Authors
- Rasmark Roepke, E., Matthiesen, L., Rylance, R., & Christiansen, O. B.
- Affiliations
- Department of Obstetrics and Gynecology Skåne University Hospital Lund University Malmö Sweden
- Lund University (SE)
- Skåne University Hospital (SE)
- Aalborg University Hospital (DK)
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2017-09-25
- Volume
- 96
- Issue
- 11
- Pages
- 1365-1372
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W2746861273
- Cited by
- 78
- References
- 28
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 9 · 2023: 15 · 2022: 10 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 5
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Funders
- Thelma Zoega Foundation
- Stig and Ragnar Gorthon Foundation
- Skåne County Council's Research and Development Foundation
- 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
- recurrent pregnancy loss, miscarriage, incidence trends, pregnancy outcomes, environmental factors
- MeSH terms
- Abortion, Spontaneous, Adolescent, Adult, Female, Humans, Pregnancy, Registries, Retrospective Studies, Risk Factors, Sweden, Incidence, Prevalence
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