Evidence map›Paper›PMID 29336062›Full record

ArticlePaediatric and perinatal epidemiology2018

Time-Varying Effects of Signs and Symptoms on Pregnancy Loss <20 Weeks: Findings from a Preconception Prospective Cohort Study.

Katherine J Sapra, Germaine M Buck Louis, Rajeshwari Sundaram, K S Joseph, Lisa M Bates, Sando Galea, Cande V Ananth

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Paediatric and perinatal epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Katherine J SapraDepartment of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.ORCID 0000-0001-5659-6489
Germaine M Buck LouisDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Rockville, MD, USA.
Rajeshwari SundaramDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Rockville, MD, USA.
K S JosephDepartment of Obstetrics and Gynaecology, School of Population and Public Health, The Children's and Women's Hospital of British Columbia, University of British Columbia, Vancouver, BC, Canada.
Lisa M BatesDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Rockville, MD, USA.
Sando GaleaDepartment of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA.
Cande V AnanthDepartment of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA.
Eunice Kennedy Shriver National Institute of Child Health and Human Development · USBoston University · USCollege of Physicians of Philadelphia · USCornell University · USUniversity of British Columbia · CA

Funding

DETERMINANTS OF MALE AND FEMALE FECUNDITY AND FERTILITY RESEARCH SITES-275033356N01HD033356 · NICHD · RESEARCH TRIANGLE INSTITUTE · 2004 to 2005
–
DETERMINANTS OF MALE AND FEMALE FECUNDITY AND FERTILITY DATA COORDINAT-275033358N01HD033358 · NICHD · THE EMMES CORPORATION · 2004 to 2005
–
NICHD NIH HHS N01 HD033355NICHD NIH HHS N01 HD033356NICHD NIH HHS N01 HD033358
6 · The paper itself

Abstract

backgroundAlthough pregnancy loss affects one-third of pregnancies, the associated signs/symptoms have not been fully described. Given the dynamic nature of maternal physiologic adaptation to early pregnancy, we posited the relationships between signs/symptoms and subsequent loss would vary weekly.

methodsIn a preconception cohort with daily follow-up, pregnancies were ascertained by self-administered sensitive home pregnancy tests on day of expected menses. We evaluated the effects of weekly time-varying signs/symptoms (including vaginal bleeding, lower abdominal cramping, and nausea and/or vomiting) on pregnancy loss <20 weeks in Cox proportional hazards models and calculated the week-specific probability of loss by the presence/absence of each sign/symptom.

resultsOf 341 pregnancies ascertained by home pregnancy test, 95 (28%) ended in loss. Relationships between signs/symptoms and loss varied across time since first positive pregnancy test. In the first week following pregnancy confirmation, when many losses occurred, bleeding [hazard ratio (HR) 8.7, 95% confidence interval (CI) 4.7, 16.0] and cramping (HR 1.8, 95% CI 1.2, 2.7) were associated with loss even when accompanied by nausea and/or vomiting (HR 5.2, 95% CI 2.6, 10.5). After the second week, new relationships emerged with nausea and/or vomiting inversely associated (HR range 0.6-0.3, all 95% CI upper bounds <1.00) and bleeding no longer associated with loss. Probabilities of loss of ranged from 78% (95% CI 59%, 96%) with bleeding present in week 1 to 8% (95% CI 5%, 12%) with nausea/vomiting present in week 5.

conclusionsRelationships between signs/symptoms and pregnancy loss vary in early pregnancy possibly reflecting maternal physiologic response.

Indexed as

Abortion, SpontaneousAdolescentAdultFemaleHumansNauseaPregnancyProspective StudiesUterine HemorrhageVomitingYoung Adultbleedingcrampingmiscarriagenauseapregnancy losssymptomstime-varying effectsvomiting

Identifiers

PMID29336062
PMCPMC5772892
OpenAlexW2745450723

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.