Reproductive Factors and Risk of Spontaneous Abortion in the Jinchang Cohort
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Data Collection
2.3. Statistical Analysis
2.4. Quality Control
3. Results
3.1. Characteristics of Participants
3.2. Distribution of Spontaneous Abortions in the Jinchang Cohort
3.3. Relationship between Reproductive Status and Spontaneous Abortion
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- World Health Organization. Manual of the International Statistical Classification of Diseases, Injures and Causes of Death; World Health Organization: Geneva, Switzerland, 1979. [Google Scholar]
- Gao, L.J. Study on Influencing Factors of Unexplained Spontaneous Abortion. Ph.D. Thesis, Shan Dong University, Jinan, China, 2013. [Google Scholar]
- Liu, B.; Gao, E.S. Risk factors for spontaneous abortion of Chinese married women at reproductive age. China Public Health 2002, 18, 890–892. [Google Scholar]
- Xie, X.; Gou, W.L. Obstetrics and Gynecology, 8th ed.; People’s Medical Publishing House: Beijing, China, 2013; pp. 47–49. ISBN 978-71-1717-180-9. [Google Scholar]
- Sun, Y.; Zhao, H. The research status of psychological problems and intervention in patients with spontaneous abortion. Chin. J. Nurs. 2013, 48, 648–651. [Google Scholar] [CrossRef]
- Morales, C.; Sánchez, A.; Bruguera, J.; Margarit, E.; Borrell, A.; Borobio, V.; Soler, A. Cytogenetic study of spontaneous abortions using semi-direct analysis of chorionic villi samples detects the broadest spectrum of chromosome abnormalities. Am. J. Med. Genet. Part A 2008, 146, 66. [Google Scholar] [CrossRef] [PubMed]
- Janowicz-Grelewska, A.; Sieroszewski, P. Prognostic significance of subchorionic hematoma for the course of pregnancy. Ginekol. Polska 2013, 84, 944–949. [Google Scholar] [CrossRef]
- Yang, Y.; Ding, L.L.; Ji, X.Q. The relationship between age, number of abortion and miscarriage outcome in patients with threatened abortion. J. Ningxia Med. Univ. 2014, 36, 229–231. [Google Scholar] [CrossRef]
- Metwally, M.; Li, T.C.; Ledger, W.L. The impact of obesity on female reproductive function. Obes. Rev. 2007, 8, 515–523. [Google Scholar] [CrossRef] [PubMed]
- Fedorcsak, P.; Storeng, R.; Dale, P.O.; Tanbo, T.; Abyholm, T. Obesity is a risk factor for early pregnancy loss after ivf or icsi. Acta Obstet. Gynecol. Scand. 2000, 79, 43–48. [Google Scholar] [CrossRef] [PubMed]
- Galamb, A.; Petho, B.; Fekete, D.; Petranyi, G.; Pajor, A. Uterine anomalies in women with recurrent pregnancy loss. Orvosi Hetilap 2015, 156, 1081–1084. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ke, R.W. Endocrine basis for recurrent pregnancy loss. Obstet. Gynecol. Clin. N. Am. 2014, 41, 103–112. [Google Scholar] [CrossRef] [PubMed]
- Zhao, N.J. Study on the Effection between Certain Elements in Ambient PM2.5 and Adverse Pregnancy Outcome and Action of Placental Barriers in Nickel-Contaminated Area. Master’s Thesis, Lanzhou University, Lanzhou, China, 2012. [Google Scholar]
- Zhang, Y.; Liao, Y.L.; Xu, B.; Wang, J.F. Impact of heavy metals in environment on neural tube defects: A review of recent studies. J. Environ. Health 2014, 31, 1100–1104. [Google Scholar] [CrossRef]
- Ou, Y.Q.; Mai, J.Z.; Nie, Z.Q.; Liu, X.Q. Relationship between maternal blood cell heavy metal content and fetal congenital heart disease. In Proceedings of the 16th South China International Conference on Cardiovascular Diseases, Guangzhou, China, 10–13 April 2014. [Google Scholar]
- Stingone, J.A.; Luben, T.J.; Daniels, J.L.; Fuentes, M.; Richardson, D.B.; Aylsworth, A.S.; Herring, A.H.; Anderka, M.; Botto, L.; Correa, A.; et al. Maternal exposure to conventional air pollutants and congenital heart defects in offspring: Results from national birth defect prevention studies. Environ. Health Perspect. 2014, 122, 863–872. [Google Scholar]
- Zheng, J.Y.; Hui, W.L.; Lan, X.X.; Hou, H.Y.; Wang, D.; Chen, Y.Q. Periconceptional exposure to air pollutants SO2, NO2 associated with birth defects. J. Int. Obstet. Gynecol. 2013, 40, 71–74. [Google Scholar]
- Hou, H.Y.; Xu, H.J.; Chen, Y.Q. Epidemiological proof between environmental chemical pollutants and pregnancy. J. Int. Obstet. Gynecol. 2011, 38, 383–385. [Google Scholar]
- Bai, Y.N.; Yang, A.M.; Pu, H.Q.; Dai, M.; Cheng, N.; Ding, J.; Li, J.S.; Li, H.Y.; Hu, X.B.; Ren, X.W.; et al. Cohort profile: The China metal-exposed workers cohort study (Jinchang cohort). Int. J. Epidemiol. 2017, 46, 1095–1096. [Google Scholar] [CrossRef] [PubMed]
- China Diabetes Society. Suggestions about metabolic syndrome of Chinese diabetes society. Chin. J. Diabetes 2004, 12, 156–161. [Google Scholar]
- Yang, A.M.; Liu, S.M.; Cheng, N.; Pu, H.Q.; Dai, M.; Ding, J.; Li, J.S.; Li, H.Y.; Hu, X.B.; Ren, X.W.; et al. Multiple metals exposure, elevated blood glucose and dysglycemia among Chinese occupational workers. J. Diabetes Complic. 2017, 31, 101–107. [Google Scholar] [CrossRef] [PubMed]
- Perloff, D.; Grim, C.; Flack, J.; Frohlich, E.D.; Hill, M.; McDonald, M.; Morgenstern, B.Z. Human blood pressure determination by sphygmomanometry. Circulation 1993, 88, 2460–2470. [Google Scholar] [CrossRef] [PubMed]
- Yang, A.M.; Liu, S.M.; Cheng, N.; Pu, H.Q.; Dai, M.; Ding, J.; Li, J.S.; Li, H.Y.; Hu, X.B.; Ren, X.W.; et al. Reproductive factors and risk of type 2 diabetes in an occupational cohort of Chinese women. J. Diabetes Complic. 2016, 30, 1217–1222. [Google Scholar] [CrossRef] [PubMed]
- Zhang, X.Y. Practical of Obstetrics and Gynecology, 2nd ed.; People’s Medical Publishing House: Beijing, China, 2003; ISBN 7117054840. [Google Scholar]
- Gao, E.S.; Deng, X.Q.; He, G.S.; Fang, K.J.; Tang, W.; Lou, C.H. Analysis of the spontaneous abortion of married women in China. Reprod. Contracept. 1993, 13, 358–366. [Google Scholar]
- Ling, W.L.; Zhang, C.C.; Li, Y.; Zhang, Y.; Feng, Z.C. Analysis of the causes of spontaneous abortion of married women at child-bearing age in five cities of China. Chin. Prim. Health Care 2004, 18, 48–51. [Google Scholar]
- Yang, S.L.; Jiang, K.F.; Gao, H.H.; Wang, K.Y.; Gong, X.L.; Zhao, J.; Cui, H.X. Analysis on the causes of spontaneous abortion of pregnant women in Yimeng mountain area. Chin. Matern. Child Health Care 2011, 26, 1514–1517. [Google Scholar]
- Li, X.Q.; Tang, H.Q. A case-control study of spontaneous abortion among female workers in a petrochemical enterprise. Occup. Health 2012, 28, 2871–2874. [Google Scholar] [CrossRef]
- Liu, X.Y.; Bian, X.M.; Han, J.X.; Cao, Z.J.; Fan, G.S.; Zhang, C.; Zhang, W.L.; Zhang, S.Z.; Sun, X.G. Risk factors in the living environment of early spontaneous abortion pregnant women. Acta Acad. Med. Sin. 2007, 29, 661–664. [Google Scholar]
- Ma, X.J.; Xiao, W.X. The study of relationship between oxidative stress and spontaneous abortion. Chin. Matern. Child Health Care 2007, 22, 622–623. [Google Scholar]
- Wang, Y.; Xu, K.H.; Xu, P. Correlations between oxidative stress factors CAT, GPX1, SOD1, SOD2, TXNL1, LOX-1 and recurrent spontaneous abortion. Chin. J. Health Lab. Technol. 2014, 24, 2515–2517. [Google Scholar]
- Hu, X.B.; Yang, Y.N.; Bai, Y.N. Logistic regression analysis of risk factors for spontaneous abortion of the hospitalized pregnant women in Lanzhou. Chin. J. Health Stat. 2010, 27, 598–599. [Google Scholar]
- Song, J.; Chen, S.L.; Sun, L.; Luo, C.; Yin, M.N.; Xiong, X.S.; Zhao, E.Y. Embryo implantation and clinical pregnancy outcomes in women of different ages. J. Pract. Med. 2008, 24, 1539–1541. [Google Scholar]
- Saraiya, M.; Berg, C.J.; Shulman, H.; Green, C.A.; Atrash, H.K. Estimates of the annual number of clinically recognized pregnancies in the United States, 1981–1991. Am. J. Epidemiol. 1999, 149, 1025–1029. [Google Scholar] [CrossRef] [PubMed]
- Xie, H.X.; Zhu, M. Analysis on the status and influencing factors of early spontaneous abortion in pregnant women in Wuyi, Zhejiang. Chin. Rural Health Serv. Adm. 2017, 37, 825–827. [Google Scholar]
- Wang, L. Discussion on the Function of Ovarian Reserve and the Rate of Pregnancy after Ovarian Cystectosis and Ovarian Cystectomy Descend or Not. Master’s Thesis, Dalian Medical University, Dalian, China, 2007. [Google Scholar]
- Clifford, K.; Rai, R.; Regan, L. Future pregnancy outcome in unexplained recurrent first trimester miscarriage. Hum. Reprod. 1997, 12, 387–389. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Category | Variable |
---|---|
Demographic characteristics | Name, gender, age, ethnicity, birthplace, date of birth, education, marital status, family income, etc. |
Living habits | Smoking and passive smoking status, drinking status, tea drinking status, physical exercise, etc. |
Eating habits | Ingestion of vegetables, fruits, meat, milk, eggs, and beans, and dietary preferences. |
Career history | Occupation, job type, occupation history, environmental exposure history, etc. |
History of personal disease | Tumors, chronic respiratory diseases, circulatory diseases, endocrine and nutritional metabolic diseases, digestive diseases, genitourinary system diseases, skin and subcutaneous tissue diseases and occupational diseases, etc. |
Family history of diseases | Cancer, hypertension, hyperlipidemia, coronary heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD), etc. |
Physiological and reproductive history | Menarche age, amenorrhea status, birth history, history of taking estrogens, history of reproductive system surgery, etc. |
Others | Mental and emotional state, etc. |
Variables | Number of Workers | % |
---|---|---|
Age, years | ||
<25 | 1093 | 5.80 |
25~ | 1778 | 9.44 |
35~ | 6893 | 36.60 |
45~ | 4428 | 23.51 |
55~ | 4642 | 24.65 |
Degree of education | ||
Uneducated | 998 | 5.30 |
Primary school | 1486 | 7.89 |
Junior middle school | 5051 | 26.83 |
High school | 4878 | 25.91 |
Junior college | 3551 | 18.86 |
Undergraduate | 2762 | 14.67 |
Master’s degree and above | 102 | 0.54 |
Tobacco smoke | ||
Yes | 343 | 1.82 |
No | 18,490 | 98.18 |
Alcohol consumption | ||
Yes | 465 | 2.60 |
No | 17,387 | 97.40 |
Age, Years | N * | Abnormal Embryonic Development | Maternal Disease | Trauma | Unknown Reasons | Fatigue | Others | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n # | % | n | % | n | % | n | % | n | % | n | % | ||
<25 | 42 | 0 | 0.00 | 2 | 4.76 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 |
25~ | 475 | 14 | 2.95 | 0 | 0.00 | 1 | 0.21 | 16 | 3.37 | 8 | 1.68 | 0 | 0.00 |
30~ | 836 | 12 | 1.44 | 10 | 1.20 | 3 | 0.36 | 35 | 4.19 | 20 | 2.39 | 0 | 0.00 |
35~ | 3058 | 40 | 1.31 | 21 | 0.69 | 28 | 0.92 | 101 | 3.30 | 129 | 4.22 | 0 | 0.00 |
40~ | 4491 | 32 | 0.71 | 30 | 0.67 | 36 | 0.80 | 125 | 2.78 | 157 | 3.50 | 6 | 0.13 |
45~ | 3443 | 23 | 0.67 | 18 | 0.52 | 28 | 0.81 | 69 | 2.00 | 129 | 3.75 | 3 | 0.09 |
50~ | 1697 | 10 | 0.59 | 8 | 0.47 | 11 | 0.65 | 62 | 3.65 | 41 | 2.42 | 0 | 0.00 |
55~ | 11,871 | 48 | 0.40 | 18 | 0.15 | 53 | 0.45 | 186 | 1.57 | 249 | 2.10 | 3 | 0.03 |
Total | 25,913 | 179 | 0.69 | 107 | 0.41 | 160 | 0.62 | 594 | 2.29 | 733 | 2.83 | 12 | 0.05 |
Variables | N * | Number of Spontaneous Abortions | rs | p | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | ≥4 | ||||||||
n# | % | n | % | n | % | n | % | ||||
Number of pregnancies | |||||||||||
1 | 5246 | 39 | 0.74 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | 0.190 | 0.000 |
2 | 7228 | 585 | 8.09 | 20 | 0.28 | 0 | 0.00 | 0 | 0.00 | ||
3 | 5731 | 312 | 5.44 | 202 | 3.52 | 0 | 0.00 | 0 | 0.00 | ||
4 | 3659 | 143 | 3.91 | 66 | 1.80 | 75 | 2.05 | 8 | 0.22 | ||
≥5 | 4049 | 121 | 2.99 | 84 | 2.07 | 54 | 1.33 | 76 | 1.88 | ||
Total | 25,913 | 1200 | 4.63 | 372 | 1.44 | 129 | 0.50 | 84 | 0.32 | ||
Age at primary birth, years | |||||||||||
<25 | 15,944 | 502 | 3.15 | 154 | 0.97 | 30 | 0.19 | 0 | 0.00 | 0.092 | 0.000 |
25~ | 8922 | 554 | 6.21 | 158 | 1.77 | 75 | 0.84 | 37 | 0.41 | ||
30~ | 657 | 76 | 11.57 | 28 | 4.26 | 18 | 2.74 | 22 | 3.35 | ||
≥35 | 249 | 10 | 4.02 | 2 | 0.80 | 6 | 2.41 | 0 | 0.00 | ||
Total | 25,772 | 1142 | 4.43 | 342 | 1.33 | 129 | 0.50 | 59 | 0.23 | ||
Age at menarche, years | |||||||||||
<12 | 1943 | 128 | 6.59 | 32 | 1.65 | 9 | 0.46 | 8 | 0.41 | −0.016 | 0.032 |
12~ | 12,260 | 673 | 5.49 | 200 | 1.63 | 72 | 0.59 | 58 | 0.47 | ||
15~ | 9960 | 356 | 3.57 | 116 | 1.16 | 42 | 0.42 | 18 | 0.18 | ||
18~ | 1750 | 43 | 2.46 | 24 | 1.37 | 6 | 0.34 | 0 | 0.00 | ||
Total | 25,913 | 1200 | 4.63 | 372 | 1.44 | 129 | 0.50 | 84 | 0.32 | ||
Age at last pregnancy, years | |||||||||||
<25 | 6333 | 269 | 4.25 | 42 | 0.66 | 9 | 0.14 | 0 | 0.00 | 0.061 | 0.000 |
25~ | 12,540 | 599 | 4.78 | 196 | 1.56 | 66 | 0.53 | 19 | 0.15 | ||
30~ | 4501 | 206 | 4.58 | 80 | 1.78 | 30 | 0.67 | 40 | 0.89 | ||
35~ | 2032 | 92 | 4.53 | 36 | 1.77 | 24 | 1.18 | 11 | 0.54 | ||
40~ | 372 | 13 | 3.49 | 8 | 2.15 | 0 | 0.00 | 0 | 0.00 | ||
≥45 | 63 | 3 | 4.76 | 2 | 3.17 | 0 | 0.00 | 6 | 9.52 | ||
Total | 25,841 | 1182 | 4.57 | 364 | 1.50 | 129 | 0.50 | 76 | 0.29 | ||
Number of artificial abortions | |||||||||||
0 | 13,608 | 791 | 5.81 | 308 | 2.26 | 111 | 0.82 | 61 | 0.45 | −0.129 | 0.000 |
1 | 7811 | 324 | 4.15 | 46 | 0.59 | 15 | 0.19 | 19 | 0.24 | ||
2 | 3583 | 72 | 2.01 | 18 | 0.50 | 0 | 0.00 | 4 | 0.11 | ||
≥3 | 911 | 13 | 1.43 | 0 | 0.00 | 3 | 0.33 | 0 | 0.00 | ||
Total | 25,913 | 1200 | 4.63 | 372 | 1.44 | 129 | 0.50 | 84 | 0.32 |
Variables | B | SE | Wald | Df | Sig. | Exp(B) | 95% CI |
---|---|---|---|---|---|---|---|
Number of pregnancies | |||||||
1 | 403.903 | 4 | 0.000 | Reference | |||
2 | 0.166 | 0.166 | 270.925 | 1 | 0.000 | 15.473 | (11.167, 21.440) |
3 | 0.169 | 0.169 | 302.099 | 1 | 0.000 | 18.888 | (13.561, 26.309) |
4 | 0.178 | 0.178 | 309.602 | 1 | 0.000 | 22.829 | (16.113, 32.345) |
≥5 | 0.179 | 0.179 | 380.875 | 1 | 0.000 | 33.180 | (23.342, 47.165) |
Age at primary birth, years | |||||||
<25 | 160.204 | 3 | 0.000 | Reference | |||
25~ | 0.460 | 0.059 | 60.931 | 1 | 0.000 | 1.584 | (1.411, 1.778) |
30~ | 1.372 | 0.121 | 128.859 | 1 | 0.000 | 3.943 | (3.111, 4.996) |
≥35 | 1.026 | 0.305 | 11.301 | 1 | 0.001 | 2.791 | (1.534, 5.078) |
Age at last pregnancy, years | |||||||
<25 | 95.767 | 5 | 0.000 | Reference | |||
25~ | 0.520 | 0.072 | 52.641 | 1 | 0.000 | 1.682 | (1.462, 1.936) |
30~ | 0.801 | 0.089 | 81.283 | 1 | 0.000 | 2.228 | (1.872, 2.652) |
35~ | 0.666 | 0.114 | 34.380 | 1 | 0.000 | 1.946 | (1.558, 2.432) |
40~ | 0.267 | 0.259 | 1.067 | 1 | 0.302 | 1.306 | (0.787, 2.169) |
≥45 | 1.264 | 0.495 | 6.510 | 1 | 0.011 | 3.538 | (1.340, 9.340) |
Number of artificial abortions | |||||||
0 | 278.732 | 3 | 0.000 | Reference | |||
1 | 1.853 | 0.272 | 46.341 | 1 | 0.000 | 6.382 | (3.743, 10.882) |
2 | 1.107 | 0.276 | 16.122 | 1 | 0.000 | 3.024 | (1.762, 5.191) |
≥3 | 0.429 | 0.293 | 2.148 | 1 | 0.143 | 1.535 | (0.865, 2.724) |
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Hu, X.; Miao, M.; Bai, Y.; Cheng, N.; Ren, X. Reproductive Factors and Risk of Spontaneous Abortion in the Jinchang Cohort. Int. J. Environ. Res. Public Health 2018, 15, 2444. https://doi.org/10.3390/ijerph15112444
Hu X, Miao M, Bai Y, Cheng N, Ren X. Reproductive Factors and Risk of Spontaneous Abortion in the Jinchang Cohort. International Journal of Environmental Research and Public Health. 2018; 15(11):2444. https://doi.org/10.3390/ijerph15112444
Chicago/Turabian StyleHu, Xiaobin, Miao Miao, Yana Bai, Ning Cheng, and Xiaowei Ren. 2018. "Reproductive Factors and Risk of Spontaneous Abortion in the Jinchang Cohort" International Journal of Environmental Research and Public Health 15, no. 11: 2444. https://doi.org/10.3390/ijerph15112444