Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857.
Singapore Med J. 2013 Aug;54(8):425-31. doi: 10.11622/smedj.2013148.
The present study aimed to assess the demographic, socioeconomic, medical and lifestyle factors associated with the progression of a threatened miscarriage to a complete miscarriage in the first trimester.
A prospective cohort study was conducted on 157 women who presented with vaginal bleeding in the fifth to tenth week of gestation. Cox regression analysis was used to determine the risk factors for progression to a complete miscarriage within 16 weeks of gestation.
Of the 139 women included for data analysis, 36 (25.9%) had a miscarriage, mostly within two weeks of presentation. The results of our study showed that women aged ≥ 34 years were more likely to miscarry (hazard ratio [HR] = 1.95). Compared to women whose partner was 20-30 years of age, women whose partner was ≥ 41 years of age also had a higher likelihood of experiencing a miscarriage (HR = 8.33). However, the presence of nausea (HR = 0.33) and a high stress score (i.e. ≥ 17) on the Perceived Stress Scale (HR = 0.49) were associated with a reduced likelihood of miscarriage.
Older pregnant women experiencing a threatened miscarriage should be counselled about their higher risk of miscarriage, especially if they have an older partner.
本研究旨在评估与早期妊娠（第 5-10 周）中难免流产进展为完全流产相关的人口统计学、社会经济学、医学和生活方式因素。
对 157 名出现阴道出血的女性进行了前瞻性队列研究。采用 Cox 回归分析确定了在 16 周内进展为完全流产的风险因素。
在纳入数据分析的 139 名女性中，36 名（25.9%）发生了流产，大多在出现症状后两周内。我们的研究结果表明，年龄≥34 岁的女性更容易流产（风险比 [HR] = 1.95）。与伴侣年龄为 20-30 岁的女性相比，伴侣年龄≥41 岁的女性流产的可能性也更高（HR = 8.33）。然而，恶心的存在（HR = 0.33）和压力量表（Perceived Stress Scale）上的高压力评分（即≥17）（HR = 0.49）与流产可能性降低有关。
对于出现难免流产的老年孕妇，应告知其流产风险更高，尤其是伴侣年龄较大的孕妇。
