MIscarriage---Causes and Top 10 Prevention Tips
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Miscarriage --- Causes and Top 10 Prevention Tips

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November 29, 2012
By ALISON TURNER, Featured Columnist

You may have heard the saying that "lots of women have miscarriages - they just don't like to talk about it".  Unfortunately, this saying may be true.  The National Libraries of Health reports that an estimated half of all fertilized eggs die and are lost without the woman realizing she was ever pregnant. The rate for women who are aware of a miscarriage runs around 15-20%, and most of these miscarriages occur during the first seven weeks of pregnancy.   What can we do for ourselves or our partners to help them from becoming part of these scary statistics?

First of all, it's important to get a few terms straight.  The word "miscarriage" refers to the loss of a fetus before the 20th week of pregnancy; a loss of pregnancy after this time is usually referred to as a "preterm delivery."   The National Libraries of Health reports that most miscarriages are caused by "chromosome problems that make it impossible for the baby to develop" - and that usually these problems are unrelated to the genes of either parent.

If we can't tie the genes of either parent to the chance of miscarriage, there are other conditions made by the parents of a fetus that could alter the risk of miscarriage.  Conditions ranging from lifestyle choices such as the use of alcohol, to hormone problems can affect the condition of the fetus.  The risk for miscarriage also increases for women who are older, increasing beginning at the age of 30, and becoming greatest after 40.

Whether or not you or your loved one has miscarried before, check out the list below of ten do's and don'ts during pregnancy, which recent studies have shown may help you follow a pregnancy through a healthy nine months.

1. Just Found Out You're Pregnant?  Celebrate With a Hot Cup of Decaf.

How many of us have been dependent on that morning cup of coffee for decades?  And, um, maybe that cup in the afternoon, as well?  Research from California suggests that for women who have recently become pregnant, cutting back on the caffeine could be a good way to reduce the risk of miscarriage. 

In 2007, Dr. De-Kun Li with the Division of Research at Kaiser Permanente in Oakland, along with colleagues,  conducted a prospective cohort study to examine how the consumption of caffeine during pregnancy affects the risk for miscarriage.  They found that daily intake of 200 mg or more of caffeine during pregnancy was "associated with an increased risk of miscarriage" when compared with no caffeine intake. 

200 mg of caffeine is approximately two six-ounce cups of regular coffee.   The good news, then, is that pregnant women can still have that morning cup of joe!  The bad news, of course, is that pregnant women can't have that morning cup of joe twice in the same day.  (Read more about caffeine and pregnancy dangers.)

2.  You Booze You Lose

There are dozens of stories out there about how much alcohol is too much alcohol for pregnant women: is that glass of wine ok on New Year's?  What about one bloody mary, just one, on Sunday mornings?

In 2012, Anne-Marie Nybo Andersen with the Department of Public Health at the University of Copenhagen, along with other researchers from various institutions in Denmark,  attempted to get to the bottom of how alcohol changes the risk for miscarriage.  Assessing data from 92,719 Danish participants showed that 55% of women abstained from alcohol during pregnancy (2.2% reported four or more drinks per week), and that "even low amounts of alcohol consumption during early pregnancy increased the risk of spontaneous abortion substantially." 

There may, however, be cause to celebrate after sixteen weeks of pregnancy: the study found "no increased risk" for fetal death with alcohol consumption after sixteen weeks of pregnancy. 

3.  Pregnant?  Consider Vitamins.

It may seem like the best that pregnant women can do to decrease their risk for miscarriage is to avoid some of the fun parts of life (see above): however, there are a few DOs out there (such as taking vitamins) to complement the DON'Ts.

In 2008 a team lead by Reem Hasan with the Department of Epidemiology at the University of North Carolina-Chapel Hill  analyzed how prenatal vitamins in early pregnancy affected miscarriage in 4,752 women, 95% of whom reported use of vitamins during early pregnancy.  524 women had a miscarriage, and "any use of vitamins during pregnancy was associated with decreased odds of miscarriage" when compared with no exposure.

Tired of being told what not to do when you're pregnant?  Take this bit of something you can do, every time you take a daily multi-vitamin.
4. Pregnancy: Perhaps a Legitimate Excuse to Skip the Gym

For most of us, the idea of lugging around an extra thirty pounds seems like exercise enough; some women, however, may want to keep up their regular, non-pregnant exercise routine.  Research from Europe suggests that pregnant women - and their fetuses --  may be better off with a few lazy days.

In 2007, M. Madsen with the Department of Child Health at the National Institute of Public Health in Copenhagen, along with other researchers,  assessed how leisure time or physical exercise changed the risk for miscarriage in over 90,000 pregnant women.  Data revealed that the risk of miscarriage "increased by amount of exercise" for women who exercised more than 7 hours per week, when compared with people who did not exercise.  Particularly, "high-impact exercise" was shown to be associated with increased risk of miscarriage.

For those adrenaline-junky mothers to be out there, this isn't as bad as it sounds: you can still exercise while pregnant, a little bit - and, "no association was seen between exercise and risk of miscarriage after 18 weeks of gestation." 

5. Obesity and Miscarriage

Pregnancy might feel like an opportunity to fall off the diet bandwagon, so to speak: hey, you're eating for two, right?  However, a recent study from Illinois advises that a pregnant woman letting her weight get too out of hand could lead to an increased risk for miscarriage.

In 2011, Dr. Stephenson Boots with the Department of Obstetrics & Gynecology at the University of Chicago  set out to determine whether obesity is associated with miscarriage in "spontaneous conception" (that is, conception that is not helped along by procedures intended to help impregnation).  Conducting a review of published studies, the team compared data of over 28,500 obese, overweight and normal-weight women (categories determined by their body mass indices) and miscarriage events.  A miscarriage rate of 13.6% was found in obese women, and 10.7% in normal-BMI women; they also found a "higher prevalence of recurrent early miscarriage in obese versus normal-BMI women."  The team concludes that "obesity is associated with a higher miscarriage rate in women who conceive spontaneously."

The trickiest part to all of this, is that if you're pregnant and obese, you're also not allowed to exercise too much (see above): perhaps knowing that obesity during pregnancy could be dangerous will get women to the gym before they're eating for two.

6. Worried About Recurrent Miscarriage?  Try Gluten Free.

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avoid coffee to prevent miscarriage
Avoid excessive amounts of coffee to prevent miscarriage.