Risk Factors for Miscarriage in Armenia

Abstract

Background: “Miscarriage is a spontaneous expulsion or extraction of an embryo or fetus weighing 500grams or less, corresponding to an expulsion prior to 20 weeks of pregnancy” (W.H.O). Miscarriage or occurs in every one in five pregnancies worldwide. Women who had in their life a miscarriage had a 45% chance to have retained tissue in their uterus, but if the required procedures are not performed a complication such as heavy bleeding can occur and without intervention there is a high probability that the woman will die. Also, women who are more predisposed to miscarriages are at risk not being able to have a full-term live birth. Objectives: Investigation of women of reproductive age with or without miscarriage to find out the prevalence of miscarriage in Armenia, as well as highlight what are the risk factors for miscarriage and what are the interactions between different risk factors. Methods and materials: Incidence density sampling will be used to assess the prevalence of miscarriage in Armenia. Two Yerevan tertiary maternity hospitals are going to be recruited for the study – Republic Institute of Reproductive Health, Perinatology, Obstetrics and Gynecology (RIRHPOG), as being a referral hospital and the other - “Erebuni” Medical center, as another hospital having a large number of births. Women from Yerevan and marzes that will participate in the study will receive care in the two selected hospitals. Study instrument includes interviewer administered questionnaire, data extraction form medical records with abstraction form, and laboratory analysis of blood test for identification of infections and chromosomal anomalies. The χ2 test, simple logistic regression and multivariate logistic regression will be used to assess the relationships between study variables. Ethical considerations: The proposal will be reviewed by the Institutional Review Board/Committee on Human Research (IRB) within College of Health Sciences at the American University of Armenia. Before starting data collection heads of maternity hospitals will be provided with a support letter. During interviews participants will be provided with oral consent form and be provided free choice to participate or not. Team and budget: Research team will include principal investigator, interviewers, nurses and data enterers. The overall study will last for six months and two weeks. The budget needed to conduct the study is 10,916,800AMD.