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1Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
2Nanchong Institute of Cerebrovascular Diseases, Nanchong, China
3Sichuan Clinical Research Center for Neurological Disease, Nanchong, China
4Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
5Department of Neurosurgery, Chongqing General Hospital, Chongqing University, Chongqing, China
© 2024, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Data availability
The current study’s data are available from the National Cancer Institute PLCO study group. Still, restrictions apply to the availability of these data, which were used under license for the current study. Any requests to access the datasets should be directed to https://cdas.cancer.gov/plco.
Conflict of interest
The authors have no conflicts of interest to declare for this study.
Funding
This work was supported by the funding from the Research and Development Foundation of Bureau of Science & Technology and Intellectual Property Nanchong City (20SXQT0081) and Research Startup Fund from Nanchong Central Hospital.
Author contributions
Conceptualization: Tang H, Li Z, Zhang Y, Wang X, Shao C. Formal analysis: Tang H, Li Z. Funding acquisition: Tang H. Methodology: Tang H, Zhang Y, Shao C. Writing – original draft: Tang H, Li Z, Zhang Y, Dai M, Wang X, Shao C. Writing – review & editing: Tang H, Dai M, Shao C.
Characteristics | Miscarriage1 | p-value3 | Stillbirth2 | p-value3 | ||||
---|---|---|---|---|---|---|---|---|
0 | 1 | ≥2 | 0 | 1 | ≥2 | |||
Sample size | 43,221 (63.0) | 16,402 (23.9) | 9,006 (13.1) | 65,123 (95.3) | 2,597 (3.8) | 623 (0.9) | ||
Age (yr)4 | 62 (58, 67) | 62 (58, 67) | 62 (58, 67) | 0.010 | 62 (58, 67) | 63 (59, 68) | 63 (59, 68) | <0.001 |
Race | <0.001 | <0.001 | ||||||
White | 38,788 (89.7) | 14,440 (88.0) | 7,626 (84.7) | 58,018 (89.1) | 2,138 (82.3) | 471 (75.6) | ||
Other | 4,433 (10.3) | 1,962 (12.0) | 1,380 (15.3) | 7,105 (10.9) | 459 (17.7) | 152 (24.4) | ||
Education level | <0.001 | <0.001 | ||||||
Under university | 21,266 (49.3) | 7,616 (46.5) | 4,143 (46.1) | 31,126 (47.9) | 1,413 (54.6) | 320 (51.4) | ||
At least university | 21,862 (50.7) | 8,755 (53.5) | 4,848 (53.9) | 33,867 (52.1) | 1,177 (45.4) | 302 (48.5) | ||
Missing | 93 | 31 | 15 | 130 | 7 | 1 | ||
Smoking status | <0.001 | <0.001 | ||||||
Never | 24,706 (57.2) | 8,921 (54.4) | 4,590 (51.0) | 36,372 (55.8) | 1,379 (53.1) | 322 (51.7) | ||
Former | 14,603 (33.8) | 5,846 (35.6) | 3,327 (36.9) | 22,532 (34.6) | 902 (34.7) | 238 (38.2) | ||
Current | 3,910 (9.0) | 1,634 (10.0) | 1,088 (12.1) | 6,215 (9.5) | 316 (12.2) | 63 (10.1) | ||
Missing | 2 | 1 | 1 | 4 | 0 | 0 | ||
Body mass index (kg/m2) | <0.001 | <0.001 | ||||||
<25 | 17,780 (41.7) | 6,575 (40.6) | 3,411 (38.5) | 26,554 (41.3) | 889 (34.9) | 230 (37.8) | ||
25–30 | 14,749 (34.6) | 5,611 (34.6) | 3,043 (34.3) | 22,212 (34.5) | 883 (34.7) | 210 (34.5) | ||
>30 | 10,117 (23.7) | 4,009 (24.7) | 2,414 (27.2) | 15,520 (24.1) | 774 (30.4) | 168 (27.6) | ||
Missing | 575 | 207 | 138 | 837 | 51 | 15 | ||
Hypertension | <0.001 | <0.001 | ||||||
No | 28,816 (67.0) | 10,784 (66.2) | 5,711 (63.8) | 43,246 (66.7) | 1,525 (59.1) | 362 (58.8) | ||
Yes | 14,194 (33.0) | 5,512 (33.8) | 3,246 (36.2) | 21,544 (33.2) | 1,057 (40.9) | 254 (41.2) | ||
Missing | 211 | 106 | 49 | 333 | 15 | 7 | ||
Heart attack | <0.001 | <0.001 | ||||||
No | 41,156 (95.7) | 15,541 (95.4) | 8,412 (94.1) | 61,865 (95.5) | 2,414 (93.6) | 575 (93.8) | ||
Yes | 1,831 (4.3) | 743 (4.6) | 531 (5.9) | 2,883 (4.4) | 165 (6.4) | 38 (6.2) | ||
Missing | 234 | 118 | 63 | 375 | 18 | 10 | ||
Diabetes mellitus | <0.001 | <0.001 | ||||||
No | 40,504 (94.2) | 15,301 (93.9) | 8,258 (92.3) | 60,930 (94.0) | 2,316 (89.8) | 560 (90.9) | ||
Yes | 2,501 (5.8) | 996 (6.1) | 693 (7.7) | 3,854 (5.9) | 262 (10.2) | 56 (9.1) | ||
Missing | 216 | 105 | 55 | 339 | 19 | 7 | ||
Arm | 0.800 | 0.870 | ||||||
Intervention | 21,708 (50.2) | 8,233 (50.2) | 4,489 (49.8) | 32,688 (50.2) | 1,312 (50.5) | 318 (51.0) | ||
Control | 21,513 (49.8) | 8,169 (49.8) | 4,517 (50.2) | 32,435 (49.8) | 1,285 (49.5) | 305 (49.0) |
Values are presented as number (%).
1 All women who reported a history of miscarriage in the questionnaire were included.
2 All women who reported a history of stillbirth in the questionnaire were included.
3 Pearson’s chi-square test was used to compare categorical variables between groups.
4 For the continuous variable age, which did not meet the assumption of normality as assessed by the Anderson-Darling and Kolmogorov-Smirnov tests, data are presented as median (interquartile range), and the Kruskal-Wallis rank sum test was used to compare median ages across groups.
Variables | Events (n) | Subjects (n) | Unadjusted | p-value | Adjusted | p-value |
---|---|---|---|---|---|---|
Miscarriage1 | ||||||
Never | 616 | 43,221 | 1.00 (reference) | 1.00 (reference) | ||
Ever | 366 | 25,408 | 1.00 (0.88, 1.14) | 0.98 | 0.96 (0.84, 1.10) | 0.58 |
0 | 616 | 43,221 | 1.00 (reference) | 1.00 (reference) | ||
1 | 223 | 16,402 | 0.95 (0.81, 1.10) | 0.47 | 0.94 (0.80, 1.10) | 0.42 |
≥2 | 143 | 9,006 | 1.10 (0.91, 1.31) | 0.33 | 1.01 (0.83, 1.22) | 0.95 |
p for trend | 0.60 | 0.80 | ||||
Stillbirth2 | ||||||
Never | 917 | 65,123 | 1.00 (reference) | 1.00 (reference) | ||
Ever | 59 | 3,220 | 1.31 (1.01, 1.70) | 0.05 | 1.07 (0.81, 1.41) | 0.63 |
0 | 917 | 65,123 | 1.00 (reference) | 1.00 (reference) | ||
1 | 36 | 2,597 | 0.99 (0.71, 1.38) | 0.93 | 0.81 (0.57, 1.15) | 0.23 |
≥2 | 23 | 623 | 2.67 (1.77, 4.04) | <0.001 | 2.24 (1.45, 3.46) | <0.001 |
p for trend | 0.01 | 0.11 |
Values are presented as hazard ratio (95% confidence interval).
1 All women who reported a history of miscarriage in the questionnaire were included; Adjusted for age, education level, smoking status, body mass index, history of hypertension, history of heart attack, history of diabetes mellitus, race, arm and stillbirth.
2 All women who reported a history of stillbirth in the questionnaire were included; Adjusted for age, education level, smoking status, body mass index, history of hypertension, history of heart attack, history of diabetes mellitus, race, arm, and miscarriage.
Characteristics | Miscarriage |
p-value |
Stillbirth |
p-value | ||||
---|---|---|---|---|---|---|---|---|
0 | 1 | ≥2 | 0 | 1 | ≥2 | |||
Sample size | 43,221 (63.0) | 16,402 (23.9) | 9,006 (13.1) | 65,123 (95.3) | 2,597 (3.8) | 623 (0.9) | ||
Age (yr) |
62 (58, 67) | 62 (58, 67) | 62 (58, 67) | 0.010 | 62 (58, 67) | 63 (59, 68) | 63 (59, 68) | <0.001 |
Race | <0.001 | <0.001 | ||||||
White | 38,788 (89.7) | 14,440 (88.0) | 7,626 (84.7) | 58,018 (89.1) | 2,138 (82.3) | 471 (75.6) | ||
Other | 4,433 (10.3) | 1,962 (12.0) | 1,380 (15.3) | 7,105 (10.9) | 459 (17.7) | 152 (24.4) | ||
Education level | <0.001 | <0.001 | ||||||
Under university | 21,266 (49.3) | 7,616 (46.5) | 4,143 (46.1) | 31,126 (47.9) | 1,413 (54.6) | 320 (51.4) | ||
At least university | 21,862 (50.7) | 8,755 (53.5) | 4,848 (53.9) | 33,867 (52.1) | 1,177 (45.4) | 302 (48.5) | ||
Missing | 93 | 31 | 15 | 130 | 7 | 1 | ||
Smoking status | <0.001 | <0.001 | ||||||
Never | 24,706 (57.2) | 8,921 (54.4) | 4,590 (51.0) | 36,372 (55.8) | 1,379 (53.1) | 322 (51.7) | ||
Former | 14,603 (33.8) | 5,846 (35.6) | 3,327 (36.9) | 22,532 (34.6) | 902 (34.7) | 238 (38.2) | ||
Current | 3,910 (9.0) | 1,634 (10.0) | 1,088 (12.1) | 6,215 (9.5) | 316 (12.2) | 63 (10.1) | ||
Missing | 2 | 1 | 1 | 4 | 0 | 0 | ||
Body mass index (kg/m2) | <0.001 | <0.001 | ||||||
<25 | 17,780 (41.7) | 6,575 (40.6) | 3,411 (38.5) | 26,554 (41.3) | 889 (34.9) | 230 (37.8) | ||
25–30 | 14,749 (34.6) | 5,611 (34.6) | 3,043 (34.3) | 22,212 (34.5) | 883 (34.7) | 210 (34.5) | ||
>30 | 10,117 (23.7) | 4,009 (24.7) | 2,414 (27.2) | 15,520 (24.1) | 774 (30.4) | 168 (27.6) | ||
Missing | 575 | 207 | 138 | 837 | 51 | 15 | ||
Hypertension | <0.001 | <0.001 | ||||||
No | 28,816 (67.0) | 10,784 (66.2) | 5,711 (63.8) | 43,246 (66.7) | 1,525 (59.1) | 362 (58.8) | ||
Yes | 14,194 (33.0) | 5,512 (33.8) | 3,246 (36.2) | 21,544 (33.2) | 1,057 (40.9) | 254 (41.2) | ||
Missing | 211 | 106 | 49 | 333 | 15 | 7 | ||
Heart attack | <0.001 | <0.001 | ||||||
No | 41,156 (95.7) | 15,541 (95.4) | 8,412 (94.1) | 61,865 (95.5) | 2,414 (93.6) | 575 (93.8) | ||
Yes | 1,831 (4.3) | 743 (4.6) | 531 (5.9) | 2,883 (4.4) | 165 (6.4) | 38 (6.2) | ||
Missing | 234 | 118 | 63 | 375 | 18 | 10 | ||
Diabetes mellitus | <0.001 | <0.001 | ||||||
No | 40,504 (94.2) | 15,301 (93.9) | 8,258 (92.3) | 60,930 (94.0) | 2,316 (89.8) | 560 (90.9) | ||
Yes | 2,501 (5.8) | 996 (6.1) | 693 (7.7) | 3,854 (5.9) | 262 (10.2) | 56 (9.1) | ||
Missing | 216 | 105 | 55 | 339 | 19 | 7 | ||
Arm | 0.800 | 0.870 | ||||||
Intervention | 21,708 (50.2) | 8,233 (50.2) | 4,489 (49.8) | 32,688 (50.2) | 1,312 (50.5) | 318 (51.0) | ||
Control | 21,513 (49.8) | 8,169 (49.8) | 4,517 (50.2) | 32,435 (49.8) | 1,285 (49.5) | 305 (49.0) |
Variables | Events (n) | Subjects (n) | Unadjusted | p-value | Adjusted | p-value |
---|---|---|---|---|---|---|
Miscarriage | ||||||
Never | 616 | 43,221 | 1.00 (reference) | 1.00 (reference) | ||
Ever | 366 | 25,408 | 1.00 (0.88, 1.14) | 0.98 | 0.96 (0.84, 1.10) | 0.58 |
0 | 616 | 43,221 | 1.00 (reference) | 1.00 (reference) | ||
1 | 223 | 16,402 | 0.95 (0.81, 1.10) | 0.47 | 0.94 (0.80, 1.10) | 0.42 |
≥2 | 143 | 9,006 | 1.10 (0.91, 1.31) | 0.33 | 1.01 (0.83, 1.22) | 0.95 |
p for trend | 0.60 | 0.80 | ||||
Stillbirth | ||||||
Never | 917 | 65,123 | 1.00 (reference) | 1.00 (reference) | ||
Ever | 59 | 3,220 | 1.31 (1.01, 1.70) | 0.05 | 1.07 (0.81, 1.41) | 0.63 |
0 | 917 | 65,123 | 1.00 (reference) | 1.00 (reference) | ||
1 | 36 | 2,597 | 0.99 (0.71, 1.38) | 0.93 | 0.81 (0.57, 1.15) | 0.23 |
≥2 | 23 | 623 | 2.67 (1.77, 4.04) | <0.001 | 2.24 (1.45, 3.46) | <0.001 |
p for trend | 0.01 | 0.11 |
Values are presented as number (%). All women who reported a history of miscarriage in the questionnaire were included. All women who reported a history of stillbirth in the questionnaire were included. Pearson’s chi-square test was used to compare categorical variables between groups. For the continuous variable age, which did not meet the assumption of normality as assessed by the Anderson-Darling and Kolmogorov-Smirnov tests, data are presented as median (interquartile range), and the Kruskal-Wallis rank sum test was used to compare median ages across groups.
Values are presented as hazard ratio (95% confidence interval). All women who reported a history of miscarriage in the questionnaire were included; Adjusted for age, education level, smoking status, body mass index, history of hypertension, history of heart attack, history of diabetes mellitus, race, arm and stillbirth. All women who reported a history of stillbirth in the questionnaire were included; Adjusted for age, education level, smoking status, body mass index, history of hypertension, history of heart attack, history of diabetes mellitus, race, arm, and miscarriage.