A prospective longitudinal population-based study of clinical miscarriage in an urban Swedish population

objective To describe the incidence of clinical miscarriage and to investigate the factors influencing the occurrence of clinical miscarriage. Design Prospective study with both cross-sectional and longitudinal comparisons. Setting City of Goteborg, Sweden. Population Population-based study in cohorts of 19-year-old women followed longitudinally. Main outcome measures Incidence of miscarriage and pregnancy outcome. Material and methods A postal questionnaire was sent to women born in 1962 and resident in the city of Goteborg in 1981 (n = 656) regarding pregnancy outcome, clinical miscarriage and other reproductive health factors. Responders in 1981 were contacted again and requested to answer a similar questionnaire every fifth year up to 2001. The same process was repeated in 1991 with women born in 1972 (n = 780) with follow up of these responders in 1996 and 2001. A third cohort of 19-year-old women born in 1982 (n = 666) was interviewed in 2001. The self-reported pregnancy data were verified from hospital files. Results Complete data were available for 341 women born in 1962 and assessed up to the age of 39 years (ever pregnant, n = 320, 94%). There were in total 887 pregnancies (live birth, n = 590, 67%; miscarriage, n = 108, 12%; legal abortion, n = 173, 20% and ectopic pregnancy, n = 16, 2%). Of the 320 'ever pregnant' women, 80 women (25%) had experienced a miscarriage. 76.3% had experienced one miscarriage, 16.3% had two miscarriages and 7.4% had three or more miscarriages. The clinical miscarriage rates in women at different ages were as follows: 20-24 years 13.5%, 25-29 years 12.3%, 30-34 years 10.3% and 35-39 years 17.5%. The corresponding miscarriage rate in the 1972 cohort followed from 19 to 29 years of age was 11%, and in the 1982 cohort assessed at 19 years of age, the miscarriage rate was 9%. No risk factor for miscarriage could be reliably identified. Conclusions Clinical miscarriage constituted 12% of all pregnancies, and one in four women who had been pregnant up to 39 years of age had experienced a miscarriage. Three or more miscarriages were experienced by 7.4%. The occurrence of a miscarriage was not influenced by the order of the pregnancy.