Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2023

Open Access 01-12-2023 | Fertility | Research

Pre-pregnancy complications - associated factors and wellbeing in early pregnancy: a Swedish cohort study

Authors: Unnur Gudnadottir, Juan Du, Luisa W. Hugerth, Lars Engstrand, Ina Schuppe-Koistinen, Eva Wiberg Itzel, Emma Fransson, Nele Brusselaers

Published in: BMC Pregnancy and Childbirth | Issue 1/2023

Login to get access

Abstract

Background

Many couples experience difficulties to become pregnant or carry a pregnancy to term due to unknown causes. Here we define pre-pregnancy complications as having prior recurrent pregnancy loss, prior late miscarriages, time to pregnancy more than one year, or the use of artificial reproductive technologies. We aim to identify factors associated with pre-pregnancy complications and poor well-being in early pregnancy.

Methods

Online questionnaire data from 5330 unique pregnancies in Sweden were collected from November 2017 – February 2021. Multivariable logistic regression modelling was used to investigate potential risk factors for pre-pregnancy complications and differences in early pregnancy symptoms.

Results

Pre-pregnancy complications were identified in 1142 participants (21%). Risk factors included diagnosed endometriosis, thyroid medication, opioids and other strong pain medication, body mass index > 25 kg/m2 and age over 35 years. Different subgroups of pre-pregnancy complications had unique risk factors. The groups also experienced different pregnancy symptoms in early pregnancy, where women that had experienced recurrent pregnancy loss were at higher risk of depression in their current pregnancy.

Conclusion

We report one of the largest pregnancy cohorts with high frequency of pre-pregnancy complications compared to the Swedish population. Prescribed drug use and body weight were the top potentially modifiable risk factors in all groups. Participants that experienced pre-pregnancy complications also had higher risk of depression and pregnancy problems in early pregnancy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Dimitriadis E, Menkhorst E, Saito S, Kutteh WH, Brosens JJ. Recurrent pregnancy loss. Nat Rev Dis Primers. 2020;6(1):98.CrossRefPubMed Dimitriadis E, Menkhorst E, Saito S, Kutteh WH, Brosens JJ. Recurrent pregnancy loss. Nat Rev Dis Primers. 2020;6(1):98.CrossRefPubMed
2.
go back to reference Pillarisetty LS, Gupta N. Recurrent Pregnancy Loss. StatPearls. Treasure Island (FL)2021. Pillarisetty LS, Gupta N. Recurrent Pregnancy Loss. StatPearls. Treasure Island (FL)2021.
3.
go back to reference Vander Borght M, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2–10.CrossRefPubMed Vander Borght M, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2–10.CrossRefPubMed
4.
go back to reference Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, et al. Female subfertility. Nat Rev Dis Primers. 2019;5(1):7.CrossRefPubMed Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, et al. Female subfertility. Nat Rev Dis Primers. 2019;5(1):7.CrossRefPubMed
6.
go back to reference Hurter H, van Vontelin S, Vokalova L, Brandl M, Baumann M, Hosli I, et al. Prevention of pre-eclampsia after infertility treatment: Preconceptional minimalisation of risk factors. Best Pract Res Clin Endocrinol Metab. 2019;33(1):127–32.CrossRefPubMed Hurter H, van Vontelin S, Vokalova L, Brandl M, Baumann M, Hosli I, et al. Prevention of pre-eclampsia after infertility treatment: Preconceptional minimalisation of risk factors. Best Pract Res Clin Endocrinol Metab. 2019;33(1):127–32.CrossRefPubMed
7.
go back to reference Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019;72(9):579–87.CrossRefPubMed Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019;72(9):579–87.CrossRefPubMed
8.
go back to reference Gnoth C, Godehardt E, Frank-Herrmann P, Friol K, Tigges J, Freundl G. Definition and prevalence of subfertility and infertility. Hum Reprod. 2005;20(5):1144–7.CrossRefPubMed Gnoth C, Godehardt E, Frank-Herrmann P, Friol K, Tigges J, Freundl G. Definition and prevalence of subfertility and infertility. Hum Reprod. 2005;20(5):1144–7.CrossRefPubMed
11.
go back to reference Iordachescu DA, Paica CI, Boca AE, Gica C, Panaitescu AM, Peltecu G et al. Anxiety, Difficulties, and Coping of Infertile Women. Healthcare (Basel). 2021;9(4). Iordachescu DA, Paica CI, Boca AE, Gica C, Panaitescu AM, Peltecu G et al. Anxiety, Difficulties, and Coping of Infertile Women. Healthcare (Basel). 2021;9(4).
12.
go back to reference Simionescu G, Doroftei B, Maftei R, Obreja BE, Anton E, Grab D, et al. The complex relationship between infertility and psychological distress (review). Exp Ther Med. 2021;21(4):306.CrossRefPubMedPubMedCentral Simionescu G, Doroftei B, Maftei R, Obreja BE, Anton E, Grab D, et al. The complex relationship between infertility and psychological distress (review). Exp Ther Med. 2021;21(4):306.CrossRefPubMedPubMedCentral
13.
go back to reference Fransson E, Gudnadottir U, Hugerth LW, Itzel EW, Hamsten M, Boulund F, et al. Cohort profile: the swedish maternal microbiome project (SweMaMi) - assessing the dynamic associations between the microbiome and maternal and neonatal adverse events. BMJ Open. 2022;12(10):e065825.CrossRefPubMedPubMedCentral Fransson E, Gudnadottir U, Hugerth LW, Itzel EW, Hamsten M, Boulund F, et al. Cohort profile: the swedish maternal microbiome project (SweMaMi) - assessing the dynamic associations between the microbiome and maternal and neonatal adverse events. BMJ Open. 2022;12(10):e065825.CrossRefPubMedPubMedCentral
14.
go back to reference Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–7.CrossRefPubMed Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–7.CrossRefPubMed
16.
go back to reference Heitmann RJ, Langan KL, Huang RR, Chow GE, Burney RO. Premenstrual spotting of >/=2 days is strongly associated with histologically confirmed endometriosis in women with infertility. Am J Obstet Gynecol. 2014;211(4):358e1–6.CrossRef Heitmann RJ, Langan KL, Huang RR, Chow GE, Burney RO. Premenstrual spotting of >/=2 days is strongly associated with histologically confirmed endometriosis in women with infertility. Am J Obstet Gynecol. 2014;211(4):358e1–6.CrossRef
17.
go back to reference Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150:782–6.CrossRefPubMed Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150:782–6.CrossRefPubMed
18.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRefPubMed Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRefPubMed
19.
go back to reference Amarenco G. Bristol Stool Chart: prospective and monocentric study of “stools introspection” in healthy subjects. Prog Urol. 2014;24(11):708–13.CrossRefPubMed Amarenco G. Bristol Stool Chart: prospective and monocentric study of “stools introspection” in healthy subjects. Prog Urol. 2014;24(11):708–13.CrossRefPubMed
20.
go back to reference Ebrahimi N, Maltepe C, Bournissen FG, Koren G. Nausea and vomiting of pregnancy: using the 24-hour pregnancy-unique quantification of Emesis (PUQE-24) scale. J Obstet Gynaecol Can. 2009;31(9):803–7.CrossRefPubMed Ebrahimi N, Maltepe C, Bournissen FG, Koren G. Nausea and vomiting of pregnancy: using the 24-hour pregnancy-unique quantification of Emesis (PUQE-24) scale. J Obstet Gynaecol Can. 2009;31(9):803–7.CrossRefPubMed
21.
go back to reference Babor T, Higgins-Biddle JC, Saunders JB, Monteiro M. The Alcohol Use Disorders Identification Test (AUDIT). In: Dependence DoMHaS, editor. World Health Organisation; 2001. Babor T, Higgins-Biddle JC, Saunders JB, Monteiro M. The Alcohol Use Disorders Identification Test (AUDIT). In: Dependence DoMHaS, editor. World Health Organisation; 2001.
22.
go back to reference Falony G, Joossens M, Vieira-Silva S, Wang J, Darzi Y, Faust K, et al. Population-level analysis of gut microbiome variation. Science. 2016;352(6285):560–4.CrossRefPubMed Falony G, Joossens M, Vieira-Silva S, Wang J, Darzi Y, Faust K, et al. Population-level analysis of gut microbiome variation. Science. 2016;352(6285):560–4.CrossRefPubMed
23.
go back to reference Zhernakova A, Kurilshikov A, Bonder MJ, Tigchelaar EF, Schirmer M, Vatanen T, et al. Population-based metagenomics analysis reveals markers for gut microbiome composition and diversity. Science. 2016;352(6285):565–9.CrossRefPubMedPubMedCentral Zhernakova A, Kurilshikov A, Bonder MJ, Tigchelaar EF, Schirmer M, Vatanen T, et al. Population-based metagenomics analysis reveals markers for gut microbiome composition and diversity. Science. 2016;352(6285):565–9.CrossRefPubMedPubMedCentral
24.
go back to reference SFOG. Behandling vid oförklarade upprepade missfall sfog.se; 2017. SFOG. Behandling vid oförklarade upprepade missfall sfog.se; 2017.
25.
go back to reference Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354. e1- e12.CrossRef Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354. e1- e12.CrossRef
26.
go back to reference Wolf WM, Wattick RA, Kinkade ON, Olfert MD. Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. Int J Environ Res Public Health. 2018;15(11). Wolf WM, Wattick RA, Kinkade ON, Olfert MD. Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. Int J Environ Res Public Health. 2018;15(11).
Metadata
Title
Pre-pregnancy complications - associated factors and wellbeing in early pregnancy: a Swedish cohort study
Authors
Unnur Gudnadottir
Juan Du
Luisa W. Hugerth
Lars Engstrand
Ina Schuppe-Koistinen
Eva Wiberg Itzel
Emma Fransson
Nele Brusselaers
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2023
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-023-05479-8

Other articles of this Issue 1/2023

BMC Pregnancy and Childbirth 1/2023 Go to the issue