Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva

Abstract

Background Retrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias. Objective To evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes. Methods Secondary analysis of 2046 women enrolled in Project Viva at ~10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight‐for‐gestational age z‐scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre‐pregnancy body mass index. Results Mean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26–34 days (reference group), 16.2% reported short cycles (≤25 days), and 9.5% reported long/irregular cycles (≥35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U‐shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk. Conclusions Variation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.

Leveraging electronic health records to identify risk factors for recurrent pregnancy loss across two medical centers: a case-control study

“…However, both of their association results were non-significant, possibly due to being under-powered. The first study (N=2,046) found a non-significant positive association between short (≤25 days) menstrual cycle length and pregnancy loss 39 . The second study (N=252) reported that individuals with short (<10 days) luteal phases in all three pre-conception menstrual cycles had a non-significant increased risk of pregnancy loss 40 .…”

“…A constellation of menstrual abnormalities were positively associated with RPL, ranging from absent/infrequent menstruation to excessive/frequent menstruation (Table 2b). Two smaller studies on menstrual abnormalities and pregnancy loss reported positive associations 38,39 . However, both of their association results were non-significant, possibly due to being under-powered.…”

Musculoskeletal Morphology and Joint Flexibility-Associated Functional Characteristics across Three Time Points during the Menstrual Cycle in Female Contemporary Dancers

“…Although in the current study, the temperature increases after ovulation averaged to 1.60 ± 0.16 °C across the MCPs, there was high variability in this outcome measure. In a 30-year analysis of human MCP temporal characteristics, the average 28-day menstrual cycle was unsupported [ 60 ], varying substantially [ 60 , 61 , 62 ]. Each woman has a central trend and variation, which changes with age [ 60 , 63 ].…”

The promise of fecundity for understanding health across the lifespan: Is menstrual cycle length informative?

“…Soria-Contreras and colleagues are to be commended for their interesting paper in Paediatric and Perinatal Epidemiology, leveraging the Project Viva pregnancy cohort to explore associations between menstrual cycle length, gravid health and perinatal outcomes. 2 Pregnant women were enrolled at approximately 10 weeks gestation at which time they were queried about usual menstrual cycle length which was categorized as ≤25, 26-34 and ≥35 days when not on the pill, breastfeeding or pregnant. Medical records were utilised to capture gravid health status defined as hypertensive disorders, gestational diabetes or impaired glucose tolerance (GDM/IGT) and perinatal outcomes such as preterm birth defined as <37 weeks' gestation, birthweight-for-gestational age z-score (BWZ) categorised in tertiles and pregnancy outcome (loss or live birth).…”

“…Soria‐Contreras and colleagues are to be commended for their interesting paper in Paediatric and Perinatal Epidemiology, leveraging the Project Viva pregnancy cohort to explore associations between menstrual cycle length, gravid health and perinatal outcomes 2 . Pregnant women were enrolled at approximately 10 weeks gestation at which time they were queried about usual menstrual cycle length which was categorized as ≤25, 26–34 and ≥35 days when not on the pill, breastfeeding or pregnant.…”