{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:43:22Z","timestamp":1789670602997,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T00:00:00Z","timestamp":1662163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite the high prevalence of miscarriages, they are not systematically registered and few epidemiological studies have been done. As Finnish health registries are comprehensive and widely used in research, we validated the Finnish register data concerning diagnostics and treatment of miscarriage, and treatment\u2010related adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We conducted a validation study regarding miscarriage\u2010related codes of diagnoses and surgical procedures in a Finnish National Hospital Discharge Registry (NHDR) by comparing the information from the NHDR with that of the hospital records. We selected a random sample of 4\u2009months during 1998\u20132016 from three hospitals, comprising 687 women aged 15\u201349 experiencing a first miscarriage during follow\u2010up. Women with diagnoses unrelated to miscarriage, or proven to be other than miscarriage, were excluded. The final sample consisted of 643 women with confirmed miscarriage, which was used for analyses regarding the diagnosis, treatment and adverse events of miscarriage treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of miscarriages registered in the NHDR were confirmed by the hospital records (positive predictive value [PPV]\u00a0=\u00a093.6% [95% confidence interval [CI] 91.8%\u201395.4%]). Different types of miscarriage were also reliably identified; spontaneous abortion with PPV\u00a0=\u00a085.6% (95% CI 80.9%\u201389.2%), missed abortion with PPV\u00a0=\u00a092.7% (95% CI 88.8%\u201395.3%) and blighted ovum with PPV\u00a0=\u00a091.1% (95% CI 84.3%\u201395.1%). The PPV of surgical treatment (62.2% [95% CI 55.7%\u201368.3%]) was lower than the PPV of non\u2010surgical treatment (93.3% [95% CI 90.5%\u201395.3%]). The diagnoses regarding adverse events of miscarriage treatment could be reliably identified. The PPV for clinical infections was 76.0% (95% CI 56.6%\u201388.5%) and for retained products of conception or\/and vaginal bleeding 96.8% (95% CI 83.8%\u201399.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The coverage of the NHDR was good concerning identification of miscarriages, different types of miscarriages and non\u2010surgical treatment. Nevertheless, there is a need for clearly defined procedural codes concerning to medical treatment of miscarriage. The register\u2010based data are reliable and practicable for both clinical evaluation and research concerning miscarriage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14445","type":"journal-article","created":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T14:24:42Z","timestamp":1662215082000},"page":"1245-1252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["National register data are of value in studies on miscarriage\u2014Validation of the healthcare register data in Finland"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4162-9764","authenticated-orcid":false,"given":"Nea","family":"Helle","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Obstetrics and Gynecology HUS Hyvink\u00e4\u00e4 Hospital  Hyvink\u00e4\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0927-0472","authenticated-orcid":false,"given":"Maarit","family":"Niinim\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Oulu University Hospital  Oulu Finland"},{"name":"PEDEGO Research Unit University of Oulu  Oulu Finland"},{"name":"Medical Research Center Oulu (MRC Oulu) University of Oulu  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9006-6780","authenticated-orcid":false,"given":"Reetta","family":"Linnakaari","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"But","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-7525","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare (THL)  Helsinki Finland"},{"name":"Departments of Molecular Medicine and Surgery, and Neurobiology Karolinska Institute  Stockholm Sweden"},{"name":"Academic Primary Health Care Center Region Stockholm  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-130X","authenticated-orcid":false,"given":"Oskari","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2450-8725","authenticated-orcid":false,"given":"Maarit","family":"Mentula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki, and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3676"},{"key":"e_1_2_12_3_1","first-page":"1","article-title":"Spontaneous abortion risks in man: data from reproductive histories collected in a medical genetics unit","volume":"16","author":"Warburton D","year":"1964","journal-title":"Am J Hum Genet"},{"key":"e_1_2_12_4_1","unstructured":"THL (National Institute for health and welfare).Statistical Report 48\/2020 \u2010 Perinatal statistics \u2013 parturients delivers and newborns 2019.2019"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7251.1708"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12694"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l869"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13860"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S13815"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2018-105592"},{"key":"e_1_2_12_11_1","first-page":"2120","article-title":"Trends in the incidence, rate and treatment of miscarriage\u2010nationwide register\u2010study in Finland","volume":"34","author":"Linnakaari R","year":"2019","journal-title":"Hum Reprod"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494812456637"},{"key":"e_1_2_12_13_1","first-page":"113","article-title":"Finnish health and social welfare registers in epidemiological research","volume":"14","author":"Gissler M","year":"2004","journal-title":"Norsk Epidemiologi"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1302417"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6283"},{"key":"e_1_2_12_16_1","unstructured":"NICE Guideline.Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. 2012 [cited 2021 Jun 27]."},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10108"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10109"},{"key":"e_1_2_12_19_1","first-page":"77","article-title":"SOGC clinical practice guidelines. Ultrasound evaluation of first trimester pregnancy complications. Number 161, June 2005","volume":"93","author":"Morin L","year":"2006","journal-title":"Int J Gynaecol Obstet"},{"key":"e_1_2_12_20_1","first-page":"75","article-title":"Office management of early pregnancy loss","volume":"84","author":"Prine LW","year":"2011","journal-title":"Am Fam Physician"},{"key":"e_1_2_12_21_1","unstructured":"NICEGuideline.Ectopic pregnancy and miscarriage: diagnosis and initial management.2019. Available from:www.nice.org.uk\/guidance\/ng126"},{"key":"e_1_2_12_22_1","unstructured":"NICEGuideline.Management of Miscarriage.2016."},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10075"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.11.002"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/RUQ.0b013e31829158c2"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b3827"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14445","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T16:19:31Z","timestamp":1741796371000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,3]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/aogs.14445"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14445","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,3]]},"assertion":[{"value":"2022-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}