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Risk factors for miscarriage among women attending an early pregnancy assessment unit (EPAU): a prospective cohort study

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Abstract

Background

Miscarriage is the most common adverse outcome in early pregnancy; however, high proportion of miscarriages are classified as unexplained. In addition, pregnant women attending early pregnancy assessment units might be more vulnerable.

Aims

The purpose of this study was to explore the risk factors that might be associated with miscarriage among women attending an early pregnancy assessment unit (EPAU).

Methods

A prospective cohort study was undertaken. The study was conducted on women attending an EPAU at a large, tertiary hospital. A detailed lifestyle questionnaire was completed. In addition, data from validated psychometric scales were collected. Participants were followed up to determine pregnancy outcome. The relative risk was calculated to estimate the probability of having a miscarriage for all independent variables.

Results

A total sample of 293 women were included in this study. Well-established risk factors for miscarriage were found in this group including advanced maternal age and high-risk pregnancy (i.e. threatened miscarriage and recurrent miscarriage). In addition, lack of emotional wellbeing did contribute to an increased risk of miscarriage. Conversely, presenting with nausea or low-medium energy levels early in pregnancy were associated with a decreased risk of miscarriage. Finally, our results did not find any association between stressful life events, general health and lifestyle factors in this group.

Conclusions

Our findings indicated that maternal, psychological and obstetric factors may have an influence on miscarriage among women attending an EPAU. The insight of a relationship between emotional wellbeing and miscarriage opens a window for prevention in this area.

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Acknowledgments

We are grateful to the women for participating in the study and giving of their time freely.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland

    Indra San Lazaro Campillo, Sarah Meaney, Niamh Spillane & Keelin O’Donoghue

  2. Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland

    Indra San Lazaro Campillo, Sarah Meaney & Paul Corcoran

  3. National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland

    Indra San Lazaro Campillo

  4. School of Public Health, University College Cork, Cork, Ireland

    Paul Corcoran

  5. The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland

    Keelin O’Donoghue

Authors
  1. Indra San Lazaro Campillo
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  2. Sarah Meaney
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  4. Niamh Spillane
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Correspondence to Indra San Lazaro Campillo.

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San Lazaro Campillo, I., Meaney, S., Corcoran, P. et al. Risk factors for miscarriage among women attending an early pregnancy assessment unit (EPAU): a prospective cohort study. Ir J Med Sci 188, 903–912 (2019). https://doi.org/10.1007/s11845-018-1955-2

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  • DOI: https://doi.org/10.1007/s11845-018-1955-2

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