Epidemiol Health.  2014;36:e2014031. 10.4178/epih/e2014031.

Predictors of miscarriage: a matched case-control study

Affiliations
  • 1Modeling of Noncommunicable Diseases Research Center and Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
  • 2Department of Health Education and Promotion, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. parvin.cheraghi@umsha.ac.ir
  • 3Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • 4Vice-Chancellor of Health Services, Hamadan University of Medical Sciences, Hamadan, Iran.

Abstract


OBJECTIVES
The risk factors for miscarriage vary across communities and countries. This study was conducted to investigate the predictors of miscarriage in the west of Iran.
METHODS
This matched case-control study was conducted in Hamadan Province from April 2013 to March 2014. Cases were selected from women who had a recent spontaneous abortion and controls were selected from women who had a recent live birth. Two controls were selected for every case and matched for date of pregnancy and area of residence. Multivariate conditional logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
RESULTS
Five hundred fifty cases were compared with 1,091 controls. The OR of miscarriage was 1.58 (95% CI=1.30-1.92) for every five-year increase in age, 0.20 (95% CI=0.14-0.28) for every live birth, and 3.43 (95% CI=2.03-5.79) for a history of previous spontaneous abortion. Compared to nulliparous women, primiparous or multiparous women had an OR of 17.85 (95% CI=6.65-47.91) for miscarriage. There was a strong association between miscarriage and abnormal amniotic status (OR, 2.46; 95% CI, 0.46-13.09) and also abnormal placenta status (OR, 10.44; 95% CI, 0.95-114.92); however, these associations were not statistically significant. No significant associations were observed between miscarriage and body mass index, previous history of stillbirth, low birth weight, congenital anomaly, ectopic pregnancy, impaired thyroid function, or high blood pressure.
CONCLUSIONS
Our study suggests that miscarriage is a multifactorial outcome associated with several modifiable and non-modifiable risk factors that may vary among different communities.

Keyword

Spontaneous abortion; Habitual abortion; Risk factors; Case-control studies; Iran

MeSH Terms

Abortion, Habitual
Abortion, Spontaneous*
Body Mass Index
Case-Control Studies*
Female
Humans
Hypertension
Infant, Low Birth Weight
Infant, Newborn
Iran
Live Birth
Logistic Models
Odds Ratio
Placenta
Pregnancy
Pregnancy, Ectopic
Risk Factors
Stillbirth
Thyroid Gland
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