{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:12:15Z","timestamp":1791763935165,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the association between periconceptual maternal diet and miscarriage risk among women with recurrent miscarriages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective multicentre cohort study (Tommy's Net).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Three university hospital research centres in the United Kingdom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>1035 women with a baseline history of two or more miscarriages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed baseline dietary data from a 10\u2010item Food Frequency Questionnaire (FFQ). For individual food category analyses, we used multivariable Poisson regression following adjustment for maternal confounders and paternal dietary patterns. For whole diet analyses, ordinal principal component analysis (PCA) was used to identify common dietary patterns. Results were presented as relative risks (RR) with 95% confidence intervals (CI) and accompanying <jats:italic>p<\/jats:italic>\u2010values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Miscarriage rate, defined as the rate of spontaneous pregnancy loss (&lt;\u200924\u2009weeks of gestation) relative to the total number of pregnancies (miscarriages and live births).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>High consumption of fruit and nuts (almonds and walnuts) was associated with lower miscarriage risk (fruit 226\/662 (34.1%) vs. 38\/77 (49.4%), RR 0.66, 95% CI 0.51 to 0.85, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; nuts 47\/152 (30.9%) vs. 220\/613 (35.9%), RR 0.73, 95% CI 0.54 to 0.98, <jats:italic>p<\/jats:italic>\u2009=\u20090.039). High red meat intake was associated with a possible increase in miscarriage risk (6\/12 (50.0%) vs. 165\/469 (35.2%), RR 1.86, 95% CI 1.10 to 3.16, <jats:italic>p<\/jats:italic>\u2009=\u20090.022). The association with miscarriage risk was unclear for other food groups, including fresh vegetables, white meat, fish, dairy, eggs, soya and chocolate, due to imprecise point estimates. Through PCA, we identified three data\u2010derived dietary patterns. Yet, no distinct relationship emerged between these dietary patterns and miscarriage risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A maternal diet rich in fresh fruits and nuts is associated with a lower miscarriage risk among women with a history of recurrent miscarriage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trail Registration<\/jats:title><jats:p>Tommy's Net (ISRCTN17732518) <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.isrctn.com\/ISRCTN17732518\">https:\/\/www.isrctn.com\/ISRCTN17732518<\/jats:ext-link>. Analysis plan (OSF zp7cs) <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/osf.io\/zp7cs\">https:\/\/osf.io\/zp7cs<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18022","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T10:38:34Z","timestamp":1732617514000},"page":"504-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Association Between Periconceptual Maternal Dietary Patterns and Miscarriage Risk in Women With Recurrent Miscarriages: A Multicentre Cohort Study"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-0419","authenticated-orcid":false,"given":"Yealin","family":"Chung","sequence":"first","affiliation":[{"name":"Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences University of Birmingham  Edgbaston UK"},{"name":"CARE Fertility Birmingham  Edgbaston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Melo","sequence":"additional","affiliation":[{"name":"Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences University of Birmingham  Edgbaston UK"},{"name":"Nuffield Department of Women's &amp; Reproductive Health, Women's Centre, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-1421","authenticated-orcid":false,"given":"Christina","family":"Easter","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham  Edgbaston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm J.","family":"Price","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham  Edgbaston UK"},{"name":"Department of Public Health Canadian University Dubai  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rima","family":"Dhillon\u2010Smith","sequence":"additional","affiliation":[{"name":"Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences University of Birmingham  Edgbaston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Quenby","sequence":"additional","affiliation":[{"name":"Division of Biomedical Sciences, Warwick Medical School University of Warwick  Warwick UK"},{"name":"Tommy's National Centre for Miscarriage Research University Hospitals Coventry and Warwickshire NHS Trust  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Devall","sequence":"additional","affiliation":[{"name":"Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences University of Birmingham  Edgbaston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arri","family":"Coomarasamy","sequence":"additional","affiliation":[{"name":"Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences University of Birmingham  Edgbaston UK"},{"name":"CARE Fertility Birmingham  Edgbaston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization \u201cPolicy Brief Preconception Care: Maximizing the Gains for Maternal and Child Health \u201dWorld Health Organization 2013."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020\u20107292(15)30034\u20105"},{"key":"e_1_2_11_4_1","unstructured":"NICE \u201cFertility Problems: Assessment and Treatment (CG156) \u201d(NICE 2017) https:\/\/www.nice.org.uk\/guidance\/cg156."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.09.029"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoad002"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2174\/1570161118666200401112955"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00682-6"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114509993606"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-S3-S4"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-111"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000032.pub3"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu8060351"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmaa156"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws349"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.010"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40748-022-00139-9"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(97)00193-7"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30312-X"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.12.035"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00041433-200202000-00002"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1079\/PHN2001252"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.3.514S"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2023.04.011"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12399"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13113754"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa213"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw341"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17484"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-017-0442-1"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665116002548"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3109\/09637486.2013.787398"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.112.003517"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1559827618769605"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3000322"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12102938"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/mnfr.202200013"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2015.03.007"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2020.02.009"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0422-1"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0540"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmaa184"},{"key":"e_1_2_11_44_1","first-page":"1","article-title":"Association of Maternal Pre\u2010Pregnancy Dietary Intake With Adverse Maternal and Neonatal Outcomes: A Systematic Review and Meta\u2010Analysis of Prospective Studies","volume":"20","author":"Cui Y.","year":"2021","journal-title":"Critical Reviews in Food Science and Nutrition"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy353"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00444-1"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.6969"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad336"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.101238"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.03.008"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.10.021"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2023.100153"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy181"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des261"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.083634"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980019001290"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.18022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T02:41:20Z","timestamp":1738723280000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.18022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,26]]},"references-count":55,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/1471-0528.18022"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.18022","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,26]]},"assertion":[{"value":"2024-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}