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Cumulative incidence of previous spontaneous abortion in Sweden in 1983-2003: a register study
(Complications in the Reproductive Life of Women)ORCID iD: 0000-0002-2577-1632
(Complications in the Reproductive Life of Women)
2006 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 6, p. 741-747Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study is to find out how common miscarriages are among women who have delivered a child. METHODS: The numbers of deliveries and miscarriages were extracted from the Swedish Medical Birth Register between 1983 and 2003. Linear regression was performed in order to investigate whether the increasing mean age of mothers or differences in pregnancy identification methods could explain the increased frequency of miscarriage. RESULTS: The reported number of miscarriages increased each year during the 21-year period, with a marked increase between 1991 and 1993 and only a slight increase during the final 10 years. For primiparous women, the frequency of reported miscarriages per delivery increased from 8.6% in 1983 to 13.9% in 2003. The corresponding figures for 2-parous women showed an increase from 14.5% to 21.3% respectively. Women aged 30-34 years had an odds ratio of 1.43 (95% CI 1.40-1.45) to suffer spontaneous abortion compared to the age group 25-29 years. Linear regression showed that an increase in mean age at delivery could only partly explain the increase in the frequency of reported miscarriages. A possible explanation could be differences in methods of identifying early pregnancy. CONCLUSION: Of all women who deliver a child, nearly 20% have experienced previous miscarriage. The increased mean age of women could only explain a small portion of the seen increase in miscarriage. The marked increase from 1991 to 1993 is interesting. Possible reasons for the increase are discussed.

Place, publisher, year, edition, pages
2006. Vol. 85, no 6, p. 741-747
Keywords [en]
Abortion, Spontaneous/*epidemiology
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27333DOI: 10.1080/00016340600627022PubMedID: 16752269OAI: oai:DiVA.org:oru-27333DiVA, id: diva2:603295
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Miscarriage: women’s experience and its cumulative incidence
Open this publication in new window or tab >>Miscarriage: women’s experience and its cumulative incidence
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many women experience miscarriage every year. Every fourth woman who has given birth reports that she has previous experience of miscarriage. In a study of all women in the Swedish Medical Birth Register 1983-2003, we found that the number of cases of self reported miscarriage had increased in Sweden during this 21 year period. This increase can be explained by the introduction of sensitive pregnancy tests around 1990, as well as an increase in the mean age of the mothers, by approximately 3 years, during the observation period. The risk of miscarriage is 13% with the first child. With subsequent pregnancies, the risk of miscarriage is 8%, 6% and 4% with the second, third and fourth child, respectively.

Thirteen of these women who had suffered a recent miscarriage were interviewed four months later, and their feelings of guilt and emptiness were explored. Their experience was that they wanted their questions to be answered, and that they wanted others to treat them as the mothers to be that they felt themselves to be. They also experienced the need for time to grieve their loss.

Measurement of grief by means of the Perinatal Grief Scale (PGS) is used in research but has also been proposed for clinical use. We have translated this psychological instrument to Swedish, back-translated and tested it in a small pilot study. In a randomized controlled study, women with early miscarriage were allocated, either to a structured visit (study group) or a regular visit (control group) to a midwife. The structured visit was conducted according to the Swanson caring theory. We could conclude that the structured visit had no significant effect on grief compared to the regular visit, as measured using the PGS. However, women with the sub-diagnosis missed abortion have significantly more grief four months after early miscarriage, regardless of visit type.

We also performed a content analysis of the tape-recorded structured follow-up visit. The code-key used was Bonanno and Kaltman’s general grief categorization. Women’s expression of grief after miscarriage was found to be very similar to the grief experienced following the death of a relative. Furthermore, the grief was found to be independent of number of children, women’s age, or earlier experience of miscarriage.

Conclusions: Every fourth woman who gives birth reports that she has also experienced early miscarriage. The experience of these women is that they have suffered a substantial loss and their reaction is grief similar to that experienced following the death of a relative.

Place, publisher, year, edition, pages
Linköping: LiU-Tryck, Linköping, Sweden, 2006. p. 68
Keywords
Miscarriage, Grief, Perinatal Grief Scale in Swedish, Follow-up visit to midwife, Medical Birth Register
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Research subject
Medicine; Nursing Science
Identifiers
urn:nbn:se:oru:diva-36196 (URN)91-85497-76-2 (ISBN)
Public defence
2006-04-07, Berzeliussalen Hälsouniversitet i Linköping, Linköping, 16:30 (Swedish)
Opponent
Supervisors
Available from: 2014-09-09 Created: 2014-08-28 Last updated: 2017-10-17Bibliographically approved

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Adolfsson, AnnsofieLarsson, Per-Göran

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