Risk score to stratify miscarriage risk levels in preconception women.

Area of Science:

• Reproductive Health
• Obstetrics and Gynecology
• Epidemiology

Background:

• Spontaneous miscarriage is a frequent pregnancy complication.
• Existing risk assessment tools for preconception are limited.
• Identifying at-risk individuals before conception is crucial for preventative strategies.

Purpose of the Study:

• To develop and validate a novel risk scoring tool for spontaneous miscarriage in the preconception period.
• To enable women to self-assess their miscarriage risk.
• To encourage lifestyle modifications for optimizing pregnancy health.

Main Methods:

• The S-PRESTO cohort study recruited Asian women aged 18-45 years attempting conception.
• A multivariable logistic regression model identified risk factors: age, ethnicity, pregnancy loss history, BMI, smoking, alcohol, and supplement intake.
• A risk score (0-17) was derived from model coefficients to estimate miscarriage risk before 16 weeks gestation.

Main Results:

• Among 465 women, 59 experienced miscarriage.
• Miscarriage rates increased with higher risk scores: 5.3% (≤3), 17.0% (4-6), 40.0% (7-8), and 46.2% (≥9).
• The risk score demonstrated good predictive ability with an AUC of 0.74 (95% CI 0.67-0.81, p<0.001).

Conclusions:

• A novel, self-administered risk score effectively predicts spontaneous miscarriage risk.
• The score categorizes women into low, intermediate, and high-risk groups.
• This tool empowers women to modify risk factors preconceptionally, potentially reducing miscarriage rates.