围孕期危险因素暴露与妊娠早期流产的关联:一项基于中国出生人口队列的前瞻性研究OA

Objective:To analyze the association between maternal periconceptional risk factors exposure and early pregnancy abortion.Methods:Pregnant women who participated in the prospective China birth cohort study between February 2018 and December 2022 were selected as subjects.Information was collected using an electronic data capture system.Multivariate Logistic regression models were used to analyze the association between periconceptional risk factors exposure and early pregnancy abortion.Results:A total of 148 439 participants were included,with a mean maternal age of 30.66±4.14 years.The incidence of early pregnancy abortion was 2.30%(3 407 cases).Multivariate Logistic regression analysis showed that advanced maternal age(OR=2.52,95%CI:2.33-2.72),postgraduate education(OR=1.20,95%CI:1.05-1.38),annual household income>400 000 CNY(OR=1.40,95%CI:1.25-1.56),progesterone/dydrogesterone use in early pregnancy(OR=1.09,95%CI:1.00-1.18),lower abdominal pain in early pregnancy(OR=1.16,95%CI:1.07-1.27),vaginal bleeding in early pregnancy(OR=1.11,95%CI:1.02-1.22),maternal smoking(OR=2.73,95%CI:1.68-4.46),maternal alcohol consumption(OR=1.26,95%CI:1.07-1.47),and household use of air pollution-related chemicals(OR=1.16,95%CI:1.05-1.28)were risk factors for early pregnancy abortion(all P<0.05).Conception assisted by assisted reproductive technology(ART)(OR=0.61,95%CI:0.52-0.72)and folic acid supplementation(OR=0.74,95%CI:0.66-0.83)reduced the risk of early pregnancy miscarriage(both P<0.05).Conclusions:Advanced maternal age,higher education level,higher annual household income,progesterone/dydrogesterone use in early pregnancy,lower abdominal pain and vaginal bleeding in early pregnancy,smoking and alcohol consumption,and household use of air pollution-related chemicals are associated with an increased risk of early pregnancy abortion.Folic acid supplementation and ART-assisted conception are associated with a decreased risk of early pregnancy abortion.