Early risk factors for miscarriage: A prospective cohort study in pregnant women

Petra C. Arck, Mirjam Rücke, Matthias Rose, J. Szekeres-Barthó, Alison J. Douglas, Maria Pritsch, Sandra M. Blois, Maike K. Pincus, Nina Bärenstrauch, Joachim W. Dudenhausen, Katrina Nakamura, Sam Sheps, Burghard F. Klapp

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Many pregnancies are lost during early gestation, but clinicians still lack tools to recognize risk factors for miscarriage. Thus, the identification of risk factors for miscarriage during the first trimester in women with no obvious risk for a pregnancy loss was the aim of this prospective cohort trial. A total of 1098 women between gestation weeks 4 and 12 in whom no apparent signs of a threatened pregnancy could be diagnosed were recruited. Demographic, anamnestic, psychometric and biological data were documented at recruitment and pregnancy outcomes were registered subsequently. Among the cases with sufficiently available data, 809 successfully progressing pregnancies and 55 subsequent miscarriages were reported. In this cohort, risk of miscarriage was significantly increased in women at higher age (>33 years), lower body mass index (≤20 kg/m2) and lower serum progesterone concentrations (≤12 ng/ml) prior to the onset of the miscarriage. Women with subsequent miscarriage also perceived higher levels of stress/demands (supported by higher concentrations of corticotrophin-releasing hormone) and revealed reduced concentrations of progesterone-induced blocking factor. These risk factors were even more pronounced in the subcohort of women (n = 335) recruited between gestation weeks 4 and 7. The identification of these risk factors and development of an interaction model of these factors, as introduced in this article, will help clinicians to recognize pregnant women who require extra monitoring and who might benefit from therapeutic interventions such as progestogen supplementation, especially during the first weeks of pregnancy, to prevent a miscarriage.

Original languageEnglish
Pages (from-to)101-113
Number of pages13
JournalReproductive BioMedicine Online
Volume17
Issue number1
Publication statusPublished - Jul 2008

Fingerprint

Spontaneous Abortion
Pregnant Women
Cohort Studies
Prospective Studies
Pregnancy
Progesterone
Corticotropin-Releasing Hormone
Progestins
First Pregnancy Trimester
Pregnancy Outcome
Psychometrics
Body Mass Index
Demography
Serum

Keywords

  • Body mass index
  • Corticotrophin-releasing hormone
  • Miscarriage
  • Progesterone
  • Risk analysis
  • Stress perception

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Arck, P. C., Rücke, M., Rose, M., Szekeres-Barthó, J., Douglas, A. J., Pritsch, M., ... Klapp, B. F. (2008). Early risk factors for miscarriage: A prospective cohort study in pregnant women. Reproductive BioMedicine Online, 17(1), 101-113.

Early risk factors for miscarriage : A prospective cohort study in pregnant women. / Arck, Petra C.; Rücke, Mirjam; Rose, Matthias; Szekeres-Barthó, J.; Douglas, Alison J.; Pritsch, Maria; Blois, Sandra M.; Pincus, Maike K.; Bärenstrauch, Nina; Dudenhausen, Joachim W.; Nakamura, Katrina; Sheps, Sam; Klapp, Burghard F.

In: Reproductive BioMedicine Online, Vol. 17, No. 1, 07.2008, p. 101-113.

Research output: Contribution to journalArticle

Arck, PC, Rücke, M, Rose, M, Szekeres-Barthó, J, Douglas, AJ, Pritsch, M, Blois, SM, Pincus, MK, Bärenstrauch, N, Dudenhausen, JW, Nakamura, K, Sheps, S & Klapp, BF 2008, 'Early risk factors for miscarriage: A prospective cohort study in pregnant women', Reproductive BioMedicine Online, vol. 17, no. 1, pp. 101-113.
Arck, Petra C. ; Rücke, Mirjam ; Rose, Matthias ; Szekeres-Barthó, J. ; Douglas, Alison J. ; Pritsch, Maria ; Blois, Sandra M. ; Pincus, Maike K. ; Bärenstrauch, Nina ; Dudenhausen, Joachim W. ; Nakamura, Katrina ; Sheps, Sam ; Klapp, Burghard F. / Early risk factors for miscarriage : A prospective cohort study in pregnant women. In: Reproductive BioMedicine Online. 2008 ; Vol. 17, No. 1. pp. 101-113.
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