Risk score to stratify miscarriage risk levels in preconception women

Choo, Xin Hui; Ku, Chee Wai; Cheung, Yin Bun; Godfrey, Keith M.; Yap, Fabian; Tan, Kok Hian; Tan, Thiam Chye; Nadarajah, Sadhana; Yap, Fabian; Colega, Marjorelee; Chong, Mary Foong‐Fong; Chan, Shiao‐Yng; Loy, See Ling; Chan, Jerry Kok Yen

doi:10.1038/s41598-021-91567-8

Cited by 5 publications

(4 citation statements)

References 51 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 12 We also repeated the main analysis using a weighted risk score. We assigned a score value for each risk factor according to the range of FRs estimated in the multivariable model 29 compared with fecundability (FR>0.8 = score 1; FR 0.7-0.8 = score 2; FR<0.7 = score 3).…”

Section: Methodsmentioning

confidence: 99%

Modifiable Risk Factor Score and Fecundability in a Preconception Cohort in Singapore

Loy

Tiong

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportanceAlthough multiple modifiable risk factors have been identified for reduced fecundability (defined as lower probability of conception within a menstrual cycle), no scoring system has been established to systematically evaluate fecundability among females who are attempting to conceive.ObjectiveTo examine the association of a risk score based on 6 modifiable factors with fecundability, and to estimate the percentage reduction in incidence of nonconception if all study participants achieved a minimal risk score level.Design, Setting, and ParticipantsThis population-based cohort study obtained data from the S-PRESTO (Singapore Preconception Study of Long-Term Maternal and Child Outcomes) prospective cohort study. Females of reproductive age who were trying to conceive were enrolled from February 2015 to October 2017 and followed for 1 year, ending in November 2018. Data were analyzed from March to May 2022.ExposuresA reduced fecundability risk score was derived by giving participants 1 point for each of the following factors: unhealthy body mass index, unhealthy diet, smoking, alcohol intake, folic acid supplement nonuser, and older maternal age. Total scores ranged from 0 to 6 and were classified into 5 levels: level 1 (score of 0 or 1), level 2 (score of 2), level 3 (score of 3), level 4 (score of 4), and level 5 (score of 5 or 6).Main Outcomes and MeasuresFecundability, measured by time to conception in cycles, was analyzed using discrete-time proportional hazards models with confounder adjustment.ResultsA total of 937 females (mean [SD] age, 30.8 [3.8] years) were included, among whom 401 (42.8%) spontaneously conceived within 1 year of attempting conception; the median (IQR) number of cycles before conception was 4 (2-7). Compared with participants with a level 1 risk score, those with level 2, 3, 4, and 5 risk scores had reductions in fecundability of 31% (adjusted fecundability ratio [FR], 0.69; 95% CI, 0.54-0.88), 41% (FR, 0.59; 95% CI, 0.45-0.78), 54% (FR, 0.46; 95% CI, 0.31-0.69) and 77% (FR, 0.23; 95% CI, 0.07-0.73), respectively. Assessment of the population attributable fraction showed that all participants achieving a minimal (level 1) risk level would be associated with a reduction of 34% (95% CI, 30%-39%) in nonconception within a year.Conclusions and RelevanceResults of this study revealed the co-occurrence of multiple modifiable risk factors for lowered fecundability and a substantially higher conception rate among participants with no or minimal risk factors. The risk assessment scoring system proposed is a simple and potentially useful public health tool for mitigating risks and guiding those who are trying to conceive.

show abstract

Section: Methodsmentioning

confidence: 99%

Modifiable Risk Factor Score and Fecundability in a Preconception Cohort in Singapore

Loy

Tiong

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

show abstract

“…Spontaneous miscarriage is multifactorial in aetiology, with biological, environmental, obstetric and lifestyle factors being shown to play a role 5 . The risks of miscarriage like increase maternal age, psychological stress e.g.…”

Section: Introductionmentioning

confidence: 99%

“…financial or marital problems, death of close relative, divorce, physical and nonphysical abuse and loss of social support associated with the likelihood of miscarriage 1,6 . Other risk factors include obesity, underweight, caffeine, alcohol, cigarette smoke, lack of dietary supplementation such as folic acid multivitamins, heavy exercise and occupation requiring heavy lifting and shift work particularly night shift work have also been shown to increase the risk of miscarriage 5,7 Quantitative studies indicate that the experience of miscarriage can negatively impact on men's and women's psychological wellbeing 8,9 . .…”

Section: Introductionmentioning

confidence: 99%

Clinical Risk Factors Associated with Miscarriage

Shaikh,

Lakho,

Shah

2024

PJMHS

View full text Add to dashboard Cite

Aim: To identify the risk factors in patient came in OPD and in emergency with sign and symptoms of miscarriage. Method: Retrospective Cross Sectional was conducted at the Department of Obstetrics & Gynaecology, Lady Willingdon Hospital Khairpur Medical College Khairpur Mir’s from 1st January 2021 to 31st December 2022. Two thousand, one hundred and thirty patients of miscarriage were enrolled. Patient with congenital abnormal foetus and still birth were not included. Results: The majority of patients were more than 35 years of age was 974 (41%). It was also noted that abortion was more common in multigravida 1215 (57%). The risk factors of abortion were 1735 (81.4%) had lack of history of taking folic acid and multivitamins. Practical Implication: Poor socioeconomic status, lack of knowledge, illiteracy, marital problems, and physical abuse are significant risk factors for miscarriage, necessitating the provision of appropriate clinical and supportive information. Conclusion: The risk factors of miscarriage include age of mother, lack of history of taking folic acid and multivitamins during antenatal period increased body mass index and previous history of miscarriage physical abuses, history of infertility and h/o of smoking Berri and Hukka are significant. Keywords: Risk factors, Miscarriage, Outpatient Department, Incidence

show abstract

“…Medical conditions aside, lifestyle factors such as body mass index (BMI), smoking exposure, alcohol consumption and dietary intake affect the chances of pregnancy [ 8 , 9 , 10 ]. Preconception micronutrient supplementation is an increasingly common practice, with 63% and 71% of Caucasian and Asian women in Australia and Singapore taking supplements, respectively [ 11 , 12 , 13 ]. Dietary micronutrient supplements, which can be taken in the form of single or multivitamins and minerals [ 14 ], have been suggested to have possible effects on fertility [ 9 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study

Tay

et al. 2022

Nutrients

Self Cite

View full text Add to dashboard Cite

Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women’s and Children’s Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95% confidence interval 1.03–1.56) and iodine (1.28, 1.00–1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31–0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.

show abstract

Risk score to stratify miscarriage risk levels in preconception women

Cited by 5 publications

References 51 publications

Modifiable Risk Factor Score and Fecundability in a Preconception Cohort in Singapore

Modifiable Risk Factor Score and Fecundability in a Preconception Cohort in Singapore

Clinical Risk Factors Associated with Miscarriage

Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study

Contact Info

Product

Resources

About