Risk score to stratify miscarriage risk levels in preconception women

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

doi:10.1038/s41598-021-91567-8

Risk score to stratify miscarriage risk levels in preconception women

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

^*Tämän työn vastaava kirjoittaja

Tutkimustuotos: Artikkeli › Tieteellinen › vertaisarvioitu

4 Sitaatiot (Scopus)

20 Lataukset (Pure)

Abstrakti

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.

Alkuperäiskieli	Englanti
Artikkeli	12111
Julkaisu	Scientific Reports
Vuosikerta	11
Numero	1
DOI - pysyväislinkit	https://doi.org/10.1038/s41598-021-91567-8
Tila	Julkaistu - 2021
OKM-julkaisutyyppi	A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Rahoitus

This work is supported by the Singapore National Research Foundation under its TCR Flagship Programme and administered by the Singapore Ministry of Health’s NMRC, Singapore—NMRC/TCR/004-NUS/2008; NMRC/ TCR/012-NUHS/2014. Singapore Institute for Clinical Sciences, A*STAR, Singapore has provided additional funding support for the project. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus + Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP), British Heart Foundation (RG/15/17/3174) and the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867). SYC is supported by a Clinician Scientist Award from the Singapore NMRC (NMRC/CSA-INV/0010/2016). JKYC is supported by the Singapore NMRC (CSA(SI)/008/2016). No role was played by the funders in the study design, data collection and analysis, decision to publish or preparation of the manuscript. The study was conducted according to the guidelines laid down in the Declaration of Helsinki. The Singhealth Centralised Institute Review Board approved the study protocol (reference 2014/692/D). All participants provided written informed consent. This study was registered at www.clinicaltrials.gov, NCT03531658 (22/05/2018). The project is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR). The funders did not take part in the conduction of this research or writing of the present manuscript. KMG, YSC and FY received reimbursement for speaking at conferences sponsored by companies selling nutritional products. KMG, YSC and SYC are part of an academic consortium that received research funding from Abbott Nutrition, Nestle and Danone. All other authors declare no competing interests. Completed disclosure of interest forms are available to view online as supporting information.

Julkaisufoorumi-taso

Jufo-taso 1

!!ASJC Scopus subject areas

General

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10.1038/s41598-021-91567-8

s41598-021-91567-8
CC BY
Final published version, 1,05 MBLisenssi: CC BY

http://urn.fi/URN:NBN:fi:tuni-202106306154Lisenssi: CC BY

Siteeraa tätä

Choo, X. H., Ku, C. W., Cheung, Y. B., Godfrey, K. M., Chong, Y. S., Shek, L. P. C., Tan, K. H., Tan, T. C., Nadarajah, S., Yap, F. K. P., Colega, M. T., Chong, M. F. F., Chan, S. Y., Loy, S. L., & Chan, J. K. Y. (2021). Risk score to stratify miscarriage risk levels in preconception women. Scientific Reports, 11(1), Artikkeli 12111. https://doi.org/10.1038/s41598-021-91567-8

@article{f5619f09dc3549d98e47b476c287b059,

title = "Risk score to stratify miscarriage risk levels in preconception women",

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{\textendash}6, 40.0\% at score 7{\textendash}8 and 46.2\% at score ≥ 9). Women with scores ≤ 3 were defined as low-risk level (< 10\% miscarriage); scores 4{\textendash}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.",

author = "Choo, \{Xin Hui\} and Ku, \{Chee Wai\} and Cheung, \{Yin Bun\} and Godfrey, \{Keith M.\} and Chong, \{Yap Seng\} and Shek, \{Lynette Pei Chi\} and Tan, \{Kok Hian\} and Tan, \{Thiam Chye\} and Sadhana Nadarajah and Yap, \{Fabian Kok Peng\} and Colega, \{Marjorelee T.\} and Chong, \{Mary Foong Fong\} and Chan, \{Shiao Yng\} and Loy, \{See Ling\} and Chan, \{Jerry Kok Yen\}",

note = "Funding Information: This work is supported by the Singapore National Research Foundation under its TCR Flagship Programme and administered by the Singapore Ministry of Health{\textquoteright}s NMRC, Singapore{\textemdash}NMRC/TCR/004-NUS/2008; NMRC/ TCR/012-NUHS/2014. Singapore Institute for Clinical Sciences, A*STAR, Singapore has provided additional funding support for the project. KMG is supported by the UK Medical Research Council (MC\_UU\_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus + Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP), British Heart Foundation (RG/15/17/3174) and the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867). SYC is supported by a Clinician Scientist Award from the Singapore NMRC (NMRC/CSA-INV/0010/2016). JKYC is supported by the Singapore NMRC (CSA(SI)/008/2016). No role was played by the funders in the study design, data collection and analysis, decision to publish or preparation of the manuscript. Funding Information: The study was conducted according to the guidelines laid down in the Declaration of Helsinki. The Singhealth Centralised Institute Review Board approved the study protocol (reference 2014/692/D). All participants provided written informed consent. This study was registered at www.clinicaltrials.gov, NCT03531658 (22/05/2018). The project is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health{\textquoteright}s National Medical Research Council (NMRC), Singapore{\textemdash}NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR). The funders did not take part in the conduction of this research or writing of the present manuscript. Funding Information: KMG, YSC and FY received reimbursement for speaking at conferences sponsored by companies selling nutritional products. KMG, YSC and SYC are part of an academic consortium that received research funding from Abbott Nutrition, Nestle and Danone. All other authors declare no competing interests. Completed disclosure of interest forms are available to view online as supporting information. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

doi = "10.1038/s41598-021-91567-8",

language = "English",

volume = "11",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Research",

number = "1",

}

TY - JOUR

T1 - Risk score to stratify miscarriage risk levels in preconception women

AU - Choo, Xin Hui

AU - Ku, Chee Wai

AU - Cheung, Yin Bun

AU - Godfrey, Keith M.

AU - Chong, Yap Seng

AU - Shek, Lynette Pei Chi

AU - Tan, Kok Hian

AU - Tan, Thiam Chye

AU - Nadarajah, Sadhana

AU - Yap, Fabian Kok Peng

AU - Colega, Marjorelee T.

AU - Chong, Mary Foong Fong

AU - Chan, Shiao Yng

AU - Loy, See Ling

AU - Chan, Jerry Kok Yen

N1 - Funding Information: This work is supported by the Singapore National Research Foundation under its TCR Flagship Programme and administered by the Singapore Ministry of Health’s NMRC, Singapore—NMRC/TCR/004-NUS/2008; NMRC/ TCR/012-NUHS/2014. Singapore Institute for Clinical Sciences, A*STAR, Singapore has provided additional funding support for the project. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), the European Union (Erasmus + Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP), British Heart Foundation (RG/15/17/3174) and the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867). SYC is supported by a Clinician Scientist Award from the Singapore NMRC (NMRC/CSA-INV/0010/2016). JKYC is supported by the Singapore NMRC (CSA(SI)/008/2016). No role was played by the funders in the study design, data collection and analysis, decision to publish or preparation of the manuscript. Funding Information: The study was conducted according to the guidelines laid down in the Declaration of Helsinki. The Singhealth Centralised Institute Review Board approved the study protocol (reference 2014/692/D). All participants provided written informed consent. This study was registered at www.clinicaltrials.gov, NCT03531658 (22/05/2018). The project is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR). The funders did not take part in the conduction of this research or writing of the present manuscript. Funding Information: KMG, YSC and FY received reimbursement for speaking at conferences sponsored by companies selling nutritional products. KMG, YSC and SYC are part of an academic consortium that received research funding from Abbott Nutrition, Nestle and Danone. All other authors declare no competing interests. Completed disclosure of interest forms are available to view online as supporting information. Publisher Copyright: © 2021, The Author(s).

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

U2 - 10.1038/s41598-021-91567-8

DO - 10.1038/s41598-021-91567-8

M3 - Article

C2 - 34103654

AN - SCOPUS:85107684041

SN - 2045-2322

VL - 11

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 12111

ER -

Risk score to stratify miscarriage risk levels in preconception women

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