A Prospective Cohort Study of Seasonal Variation in Spontaneous Abortion.
Journal
Epidemiology (Cambridge, Mass.)
ISSN: 1531-5487
Titre abrégé: Epidemiology
Pays: United States
ID NLM: 9009644
Informations de publication
Date de publication:
01 05 2022
01 05 2022
Historique:
pubmed:
26
2
2022
medline:
8
4
2022
entrez:
25
2
2022
Statut:
ppublish
Résumé
Up to 30% of pregnancies end in spontaneous abortion, yet few risk factors have been identified. Examining seasonal patterns in risk of spontaneous abortion can generate new hypotheses regarding environmental and lifestyle determinants. We used data from Pregnancy Study Online-a preconception cohort study of pregnancy planners from the United States and Canada-to examine seasonal variation in spontaneous abortion risk. We enrolled 12,197 women during 2013 to 2020, 6104 of whom reported a conception within 12 months of enrollment. On follow-up questionnaires, participants reported date of spontaneous abortion and weeks gestation at time of loss. We used periodic regression to estimate two aspects of seasonal occurrence: peak/low ratio-a measure of intensity of seasonal variation-and peak timing. We examined season at risk (from the date of each gestational week) in relation to spontaneous abortion; in a secondary analysis, we examined season of conception in relation to spontaneous abortion. We controlled for seasonal patterns in attempt initiation via month the pregnancy attempt began. Almost 20% of women experienced spontaneous abortion. Risk was highest in late August, with a peak/low ratio of 1.3 (95% confidence interval [CI] = 1.1, 1.6). This seasonal pattern was evident almost exclusively for spontaneous abortion at <8 weeks since the last menstrual period date (peak/low ratio = 1.4; 95% CI = 1.2, 1.8), and associations were stronger among women living in the Southern and Midwestern United States. Environmental or lifestyle factors more prevalent in late summer may be associated with increased risk of early spontaneous abortion.
Sections du résumé
BACKGROUND
Up to 30% of pregnancies end in spontaneous abortion, yet few risk factors have been identified. Examining seasonal patterns in risk of spontaneous abortion can generate new hypotheses regarding environmental and lifestyle determinants.
METHODS
We used data from Pregnancy Study Online-a preconception cohort study of pregnancy planners from the United States and Canada-to examine seasonal variation in spontaneous abortion risk. We enrolled 12,197 women during 2013 to 2020, 6104 of whom reported a conception within 12 months of enrollment. On follow-up questionnaires, participants reported date of spontaneous abortion and weeks gestation at time of loss. We used periodic regression to estimate two aspects of seasonal occurrence: peak/low ratio-a measure of intensity of seasonal variation-and peak timing. We examined season at risk (from the date of each gestational week) in relation to spontaneous abortion; in a secondary analysis, we examined season of conception in relation to spontaneous abortion. We controlled for seasonal patterns in attempt initiation via month the pregnancy attempt began.
RESULTS
Almost 20% of women experienced spontaneous abortion. Risk was highest in late August, with a peak/low ratio of 1.3 (95% confidence interval [CI] = 1.1, 1.6). This seasonal pattern was evident almost exclusively for spontaneous abortion at <8 weeks since the last menstrual period date (peak/low ratio = 1.4; 95% CI = 1.2, 1.8), and associations were stronger among women living in the Southern and Midwestern United States.
CONCLUSIONS
Environmental or lifestyle factors more prevalent in late summer may be associated with increased risk of early spontaneous abortion.
Identifiants
pubmed: 35213511
doi: 10.1097/EDE.0000000000001474
pii: 00001648-202205000-00018
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-448Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
L.A.W. is a consultant for AbbVie, Inc., and accepts in-kind donations from Swiss Precision Technologies, Sandstone Diagnostics, FertilityFriend.com, and Kindara for primary data collection in Pregnancy Study Online. The remaining authors report no conflicts of interest.
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