Miscarriage risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk Factors

Pregnancies involving more than one fetus are at increased risk of miscarriage.

Uncontrolled diabetes greatly increases the risk of miscarriage. Women with controlled diabetes are not at higher risk of miscarriage. Because diabetes may develop during pregnancy (gestational diabetes), an important part of prenatal care is to monitor for signs of the disease.

Polycystic ovary syndrome is a risk factor for miscarriage, with 30-50% of pregnancies in women with PCOS being miscarried in the first trimester. Two studies have shown treatment with the drug metformin to significantly lower the rate of miscarriage in women with PCOS (the metformin-treated groups experienced approximately one-third the miscarriage rates of the control groups).[1] However, a 2006 review of metformin treatment in pregnancy found insufficient evidence of safety and did not recommend routine treatment with the drug.[2]

High blood pressure and certain illnesses (such as rubella and chlamydia) increase the risk of miscarriage.

Tobacco (cigarette) smokers have an increased risk of miscarriage.[3] An increase in miscarriage is also associated with the father being a cigarette smoker.The husband study observed a 4% increased risk for husbands who smoke less than 20 cigarettes/day, and an 81% increased risk for husbands who smoke 20 or more cigarettes/day.

Severe cases of hypothyroidism increase the risk of miscarriage. The effect of milder cases of hypothyroidism on miscarriage rates has not been established. Certain immune conditions such as autoimmune diseases greatly increase the risk of miscarriage.

Cocaine use increases miscarriage rates.[3]

Physical trauma, exposure to environmental toxins [4], obesity, high caffeine intake (> 300 mg/day), high levels of alcohol consumption, high fever (100°F or higher) , use of an IUD during the time of conception [4] and use of NSAIDs have also been linked to increased risk of miscarriage.


  1. Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE (2002). "Effects of metformin on early pregnancy loss in the polycystic ovary syndrome". J. Clin. Endocrinol. Metab. 87 (2): 524–9. PMID 11836280. Retrieved 2007-07-17.
    Khattab S, Mohsen IA, Foutouh IA, Ramadan A, Moaz M, Al-Inany H (2006). "Metformin reduces abortion in pregnant women with polycystic ovary syndrome". Gynecol. Endocrinol. 22 (12): 680–4. doi:10.1080/09513590601010508. PMID 17162710.
  2. Lilja AE, Mathiesen ER (2006). "Polycystic ovary syndrome and metformin in pregnancy". Acta obstetricia et gynecologica Scandinavica. 85 (7): 861–8. doi:10.1080/00016340600780441. PMID 16817087.
  3. 3.0 3.1 Ness R, Grisso J, Hirschinger N, Markovic N, Shaw L, Day N, Kline J (1999). "Cocaine and tobacco use and the risk of spontaneous abortion". N Engl J Med. 340 (5): 333–9. PMID 9929522.
  4. 4.0 4.1 "Miscarriage: An Overview". Armenian Medical Network. 2005. Retrieved 2007-09-19.

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