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Miscarriage risk by age, and what those numbers count

Ten percent at the lowest, rising steeply after 30. The denominator matters.

Every pregnancy from 2009 to 2013 in Norway, 421,201 in all, linked across three national registers:

Mother's ageRisk of miscarriage
25 to 2910%, the lowest point
45 and over53%

The risk rose rapidly after age 30. Having had a previous miscarriage also raised the risk, and the more there had been, the higher it went: one prior loss gave an age-adjusted odds ratio of 1.54, two gave 2.21, three gave 3.97.

What these figures are countingThese are miscarriages of recognised pregnancies. Very early losses, before a test would turn positive or before a woman would notice, are not counted here at all. So this is not the chance that an embryo fails. It is the chance that a pregnancy you know about ends.

An older Danish study covering 1978 to 1992 reported much higher figures at the top of the range, 74.7% at age 45 and over. The two are not reconcilable as a single number. The Danish study counted losses that led to hospital admission, in an era of much less early pregnancy testing, and used a different denominator. This guide leads with the Norwegian figures because they are recent and the ascertainment is more complete, and it declines to present 74.7% as "the" risk at 45.

Miscarriage after a positive test is common at every age. It is also, for most women, followed by a successful pregnancy. Neither of those facts makes it a small event, and nobody should tell you it is.

Where this comes from:
18. Magnus MC, Wilcox AJ, Morken NH, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019;364:l869.
131. Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000;320(7251):1708-1712.

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