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Clinical Obstetrics

Poster Session 1

(205) Predicting Miscarriage Risk in Individuals with Chronic Illnesses

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

This study aimed to predict the risk of spontaneous abortion associated with pre-existing chronic illnesses and other known risk factors before pregnancy.

Study Design:

We conducted an observational retrospective study using extensive data from all live births and abortions between the years 2010 to 2019 in a big health maintenance organization (HMO). By analyzing diagnostic codes from patient registries, we identified 18 chronic diseases relevant only if diagnosed before the pregnancy of interest. Miscarriage risk according to underlying diseases and other risk factors were estimated using odds ratios (ORs) using logistic regression adjusting for woman's age, BMI, socioeconomic status, and smoking. Based on the ORs, we created a risk score ranging from 0 to 20.

Results:

During the study period, a total of 359,983 live births and 39,475 abortions were included. We observed an increased risk of miscarriage among women with diabetes type 2 (OR 1.23, 95% CI 1.12 to 1.35), neurology diseases (OR 2.38, 95% CI 1.79 to 3.14), depression (OR 1.43, 95% CI 1.33 to 1.54), polycystic ovary syndrome (OR 1.4, 95% CI 1.27 to 1.54), rheumatology diseases (OR 1.48, 95% CI 1.3 to 1.67), hypothyroidism (OR 1.31, 95% CI 1.28 to 1.33), hyperthyroidism & parathyroid diseases (OR 1.25, 95% CI 1.06 to 1.47), and cardiac diseases (OR 1.39, 95% CI 1.31 to 1.47). Additionally, we identified other known risk factors. The final multivariate model, as presented in Figure 1, exhibits a strong predictive ability with a mean-squared error (MSE) of 0.088. According to this model, a 37-year-old IVF patient with a BMI of 39 and two chronic diseases is subject to a 26.4% risk of abortion. In contrast, a 22-year-old woman with a BMI of 18 and no underlying chronic conditions has a significantly lower abortion risk at 8.8%.

Conclusion:

We have identified several chronic diseases and other risk factors associated with spontaneous abortion and developed a highly predictive model. However, validation of the model in an independent population is required.