Pre-pregnancy lifestyle characteristics and risk of miscarriage: the Australian Longitudinal Study on Women's Health.
Abortion, Induced
/ statistics & numerical data
Abortion, Spontaneous
/ epidemiology
Adult
Alcohol Drinking
/ epidemiology
Australia
/ epidemiology
Body Mass Index
Cohort Studies
Female
Humans
Life Style
Longitudinal Studies
Pregnancy
Prospective Studies
Risk Factors
Smoking
/ epidemiology
Women's Health
Alcohol
Body-mass index
Miscarriage
Smoking
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
01 Mar 2022
01 Mar 2022
Historique:
received:
18
08
2021
accepted:
16
02
2022
entrez:
2
3
2022
pubmed:
3
3
2022
medline:
17
3
2022
Statut:
epublish
Résumé
Previous studies of lifestyle characteristics and risk of miscarriage have mostly been retrospective and failed to account for induced abortions. We examine whether pre-pregnancy body-mass index, alcohol intake and smoking influence the risk of miscarriage after accounting for induced abortions. We conducted a prospective cohort study of 9213 women with 26,594 pregnancies participating in the Australian Longitudinal Study on Women's Health. We examined whether body-mass index, smoking and alcohol intake prior to pregnancy was associated with miscarriage. We estimated adjusted relative risks (RR) using generalized estimating equations with an exchangeable correlation matrix. We explored the impact of accounting for induced abortion by first excluding all induced abortions, and secondly including 50% of induced abortions in the comparison group. Of the 26,592 pregnancies which occurred during the follow-up period, 19% ended in a miscarriage. We observed an increased risk of miscarriage according to pre-pregnancy obesity compared to normal weight (adjusted RR 1.13; 95% CI 1.05, 1.21), smoking between 10 and 19 cigarettes per day compared to not smoking (adjusted RR 1.13; 95% CI 1.02, 1.25), but not smoking 20 or more cigarettes per day (adjusted RR 1.07; 95% CI 0.94, 1.21) and risky drinking (≥2 units per day; adjusted RR 1.15; 95% CI 1.03, 1.28) compared to low risk drinking (< 2 units per day). The results for smoking (adjusted RR 1.09 for 10-19 cigarettes per day; 95% CI 0.98, 1.21) was attenuated after including 50% of induced abortions in the comparison group. We observed a modest increased risk of miscarriage according to obesity and risky alcohol intake prior to pregnancy. There was no evidence of a dose-response relationship with smoking, and the association between smoking and risk of miscarriage was attenuated after accounting for induced abortions.
Sections du résumé
BACKGROUND
BACKGROUND
Previous studies of lifestyle characteristics and risk of miscarriage have mostly been retrospective and failed to account for induced abortions. We examine whether pre-pregnancy body-mass index, alcohol intake and smoking influence the risk of miscarriage after accounting for induced abortions.
METHODS
METHODS
We conducted a prospective cohort study of 9213 women with 26,594 pregnancies participating in the Australian Longitudinal Study on Women's Health. We examined whether body-mass index, smoking and alcohol intake prior to pregnancy was associated with miscarriage. We estimated adjusted relative risks (RR) using generalized estimating equations with an exchangeable correlation matrix. We explored the impact of accounting for induced abortion by first excluding all induced abortions, and secondly including 50% of induced abortions in the comparison group.
RESULTS
RESULTS
Of the 26,592 pregnancies which occurred during the follow-up period, 19% ended in a miscarriage. We observed an increased risk of miscarriage according to pre-pregnancy obesity compared to normal weight (adjusted RR 1.13; 95% CI 1.05, 1.21), smoking between 10 and 19 cigarettes per day compared to not smoking (adjusted RR 1.13; 95% CI 1.02, 1.25), but not smoking 20 or more cigarettes per day (adjusted RR 1.07; 95% CI 0.94, 1.21) and risky drinking (≥2 units per day; adjusted RR 1.15; 95% CI 1.03, 1.28) compared to low risk drinking (< 2 units per day). The results for smoking (adjusted RR 1.09 for 10-19 cigarettes per day; 95% CI 0.98, 1.21) was attenuated after including 50% of induced abortions in the comparison group.
CONCLUSIONS
CONCLUSIONS
We observed a modest increased risk of miscarriage according to obesity and risky alcohol intake prior to pregnancy. There was no evidence of a dose-response relationship with smoking, and the association between smoking and risk of miscarriage was attenuated after accounting for induced abortions.
Identifiants
pubmed: 35232386
doi: 10.1186/s12884-022-04482-9
pii: 10.1186/s12884-022-04482-9
pmc: PMC8887017
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
169Subventions
Organisme : H2020 European Research Council
ID : 947684
Organisme : Norges Forskningsråd
ID : 262700
Organisme : Norges Forskningsråd
ID : 262700
Organisme : National Health and Medical Research Council
ID : APP1121844
Informations de copyright
© 2022. The Author(s).
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