Social patterns of miscarriage reporting and risk: insights from survey data in France.

IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
M C Compans, Heini Väisänen
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引用次数: 0

Abstract

Miscarriages, which are spontaneous pregnancy losses before 20-28 weeks of gestation, affect approximately 15% of recognized pregnancies. Existing population-based evidence of social inequalities in miscarriage risk is inconsistent, partly due to a lack of data. Surveys can be representative of a national population but are subject to underreporting of miscarriages. We examine whether miscarriages are underreported in a French nationally representative survey, FECOND (2010-11), and analyse socioeconomic risk factors for miscarriage. First, we apply a model that estimates miscarriage underreporting. Second, we use multilevel multinomial logistic regressions to examine socio-demographic and epidemiological factors associated with miscarriage. We estimate that 92% of miscarriages were reported, and underreporting was slightly more pronounced among lower-educated women. The estimated prevalence of miscarriages (14% of all pregnancies) is unaffected by underreporting rates and only with small educational differences. Thus, investigating social disparities in miscarriage risk can be done without correcting for reporting bias. Advanced reproductive ages are associated with higher miscarriage risk. Unobserved time-consistent individual characteristics explain the association between miscarriage risk and prior reproductive history. Conversely, education and self-assessed financial conditions are not associated with miscarriage risk. Younger cohorts exhibit a higher miscarriage risk, suggesting an age effect on recall, a cohort effect on pregnancy recognition, or reduced stigma resulting in more reliable reporting of miscarriage. In sum, the miscarriage reporting rate in FECOND survey is relatively high and with only slight social disparities. No large socioeconomic differences were found in miscarriage risk.

流产报告和风险的社会模式:来自法国调查数据的见解。
流产是指在妊娠20-28周之前自然流产,约占已确认妊娠的15%。现有的基于人口的流产风险社会不平等的证据是不一致的,部分原因是缺乏数据。调查可以代表全国人口,但容易漏报流产。我们研究了法国全国代表性调查FECOND(2010-11)中流产是否被低估,并分析了流产的社会经济风险因素。首先,我们应用一个模型来估计流产漏报。其次,我们使用多水平多项逻辑回归来检查与流产相关的社会人口和流行病学因素。我们估计有92%的流产被报告了,而在受教育程度较低的女性中,漏报的情况略显明显。流产的估计流行率(占所有怀孕的14%)不受漏报率的影响,只有很小的教育差异。因此,调查流产风险的社会差异可以在不纠正报告偏差的情况下完成。较高的生育年龄与较高的流产风险相关。未观察到的时间一致的个体特征解释了流产风险与既往生育史之间的关联。相反,教育程度和自我评估的财务状况与流产风险无关。年轻的队列显示出更高的流产风险,这表明年龄对回忆有影响,队列对妊娠识别有影响,或者耻辱减少导致更可靠的流产报告。综上所述,妇联调查的流产报告率相对较高,社会差异很小。在流产风险方面没有发现大的社会经济差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Journal of Public Health
European Journal of Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.60
自引率
2.30%
发文量
2039
审稿时长
3-8 weeks
期刊介绍: The European Journal of Public Health (EJPH) is a multidisciplinary journal aimed at attracting contributions from epidemiology, health services research, health economics, social sciences, management sciences, ethics and law, environmental health sciences, and other disciplines of relevance to public health. The journal provides a forum for discussion and debate of current international public health issues, with a focus on the European Region. Bi-monthly issues contain peer-reviewed original articles, editorials, commentaries, book reviews, news, letters to the editor, announcements of events, and various other features.
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