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Title: Risk score to stratify miscarriage risk levels in preconception women
Authors: Xin Hui Choo
Chee Wai Ku 
Yin Bun Cheung 
Keith M Godfrey
Yap-Seng Chong 
Lynette Pei-Chi Shek 
Kok Hian Tan 
Thiam Chye Tan 
Sadhana Nadarajah 
Fabian Kok Peng Yap 
Marjorelee T Colega 
Mary Foong-Fong Chong 
Shiao-Yng Chan 
See Ling Loy 
Jerry Kok Yen Chan 
Issue Date: 8-Jun-2021
Publisher: Nature Research
Citation: Xin Hui Choo, Chee Wai Ku, Yin Bun Cheung, Keith M Godfrey, Yap-Seng Chong, Lynette Pei-Chi Shek, Kok Hian Tan, Thiam Chye Tan, Sadhana Nadarajah, Fabian Kok Peng Yap, Marjorelee T Colega, Mary Foong-Fong Chong, Shiao-Yng Chan, See Ling Loy, Jerry Kok Yen Chan (2021-06-08). Risk score to stratify miscarriage risk levels in preconception women. Scientific reports 11 (1) : 12111. ScholarBank@NUS Repository.
Abstract: Spontaneous miscarriage is one of the most common complications of pregnancy. Even though some risk factors are well documented, there is a paucity of risk scoring tools during preconception. In the S-PRESTO cohort study, Asian women attempting to conceive, aged 18-45 years, were recruited. Multivariable logistic regression model coefficients were used to determine risk estimates for age, ethnicity, history of pregnancy loss, body mass index, smoking status, alcohol intake and dietary supplement intake; from these we derived a risk score ranging from 0 to 17. Miscarriage before 16 weeks of gestation, determined clinically or via ultrasound. Among 465 included women, 59 had miscarriages and 406 had pregnancy ≥ 16 weeks of gestation. Higher rates of miscarriage were observed at higher risk scores (5.3% at score ≤ 3, 17.0% at score 4–6, 40.0% at score 7–8 and 46.2% at score ≥ 9). Women with scores ≤ 3 were defined as low-risk level (< 10% miscarriage); scores 4–6 as intermediate-risk level (10% to < 40% miscarriage); scores ≥ 7 as high-risk level (≥ 40% miscarriage). The risk score yielded an area under the receiver-operating-characteristic curve of 0.74 (95% confidence interval 0.67, 0.81; p < 0.001). This novel scoring tool allows women to self-evaluate their miscarriage risk level, which facilitates lifestyle changes to optimize modifiable risk factors in the preconception period and reduces risk of spontaneous miscarriage.
Source Title: Scientific reports
ISSN: 20452322
DOI: 10.1038/s41598-021-91567-8
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