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Theriogenology2018; 124; 18-23; doi: 10.1016/j.theriogenology.2018.10.008

Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares.

Abstract: Early pregnancy loss (EPL) between days 15-65 after breeding has been shown to occur in 7.9% of equine pregnancies with substantial economical, welfare and safety implications. Whilst maternal age has been recognised as an important risk factor in relation to the incidence of EPL, few other risk factors have been conclusively identified. Further, multivariable data analysis of risk factors for EPL is sparse. A prospective cohort investigation of thoroughbred broodmares in the United Kingdom was conducted over the 2013 and 2014 breeding seasons. Information relating to 28 factors including mare, stallion, pregnancy and therapeutic interventions was collected using questionnaires and entered into a custom-designed Microsoft Access database. Mixed effects logistic regression was used to determine risk factors for EPL, including 'mare' as a random effect to account for repeat pregnancies in the same mare. Stallion, stud and veterinarian were also evaluated as random effects. Variables with a p-value of <0.25 in univariable analysis were taken forward for consideration in the multivariable model which was built using a forward stepwise approach. Data were collected on 2245 pregnancies in 1753 mares. Increasing mare age (OR = 1.11, 95% confidence interval (CI) = 1.04, 1.18, p = 0.001), having had one previous foal (OR = 3.52, 95% CI = 1.56, 7.95, p = 0.002) and presence of uterine cysts (OR = 1.76, 95% CI = 1.07, 2.91, p = 0.03) were all associated with increased odds of EPL following multivariable analysis. Increasing day 15/16 scan vesicle size (OR = 0.24, 95% CI = 0.16, 0.38, p < 0.001) and the use of ovulatory induction agents (OR = 0.31, 95% CI = 0.17, 0.55, p < 0.001) were negatively associated with EPL. Stallion, stud and veterinarian were not significantly associated with EPL. Analysis of a subpopulation of 344 multiple (twin and triplet) pregnancies found that the use of flunixin meglumine at the time of manual reduction of a multiple pregnancy resulted in reduced odds of EPL (OR = 0.34, 95% CI = 0.14, 0.84, p = 0.02). Results from this study can be used by stud farm personnel when assessing their broodmare population and by clinicians when deciding upon therapeutic strategies. Additional work can be focused around these risk factors to further our understanding of the pathophysiology of EPL.
Copyright © 2018 Elsevier Inc. All rights reserved.
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Publication Date: 2018-10-09 PubMed ID: 30326374DOI: 10.1016/j.theriogenology.2018.10.008Google Scholar: Lookup
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Summary

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This research sought to understand the factors contributing to early pregnancy loss in thoroughbred broodmares, revealing age, uterine cysts, and having had one previous foal as significant risk factors, while larger day 15/16 scan vesicle size and use of ovulatory induction agents correlated with lower odds of pregnancy loss.

Objective of the Study

  • The primary objective of the study was to determine the risk factors associated with early pregnancy loss (EPL) in thoroughbred broodmares.
  • The researchers sought to fill gaps in the knowledge about EPL risk factors beyond maternal age, hoping to guide stud farm personnel in assessing broodmares and clinicians in developing therapeutic strategies.

Methodology

  • The researchers conducted a prospective cohort investigation on thoroughbred broodmares in the UK during the 2013 and 2014 breeding seasons.
  • A total of 28 potential risk factors were evaluated through the use of questionnaires and entered into a custom-designed Microsoft Access database.
  • The risk factor collection categories included mare (mother), stallion (father), pregnancy conditions, and any therapeutic interventions.
  • An advanced statistical method, mixed effects logistic regression, was used to identify significant risk factors for EPL, accounting for potential repeated pregnancies of single mares, as well as variations across individual stallions, studs, and veterinarians.
  • At each step, risk factors with a high likelihood of effecting the outcome (p-value <0.25) were brought forward for further consideration.

Results

  • Data were gathered on a total of 2245 pregnancies from 1753 mares.
  • Increasing mare age, having had one previous foal, and presence of uterine cysts emerged as factors associated with higher odds of EPL after multivariable analysis.
  • Conversely, larger day 15/16 scan vesicle size and the use of ovulatory induction agents were correspondingly linked to lower incidences of EPL.
  • The study revealed that stallion, stud, and veterinarian made no significant impact on EPL.
  • Analysis of a subpopulation of multiple pregnancies (344 twin and triplet pregnancies) found that use of a certain nonsteroidal anti-inflammatory drug at the time of manual reduction of a multiple pregnancy was associated with decreased odds of EPL.

Conclusion

  • The findings of this research provide valuable insights that will help stud farm personnel in evaluating their broodmare population and also assist clinicians in choosing therapeutic strategies.
  • Further research can build upon these newfound risk factors to better comprehend the pathophysiology of EPL in thoroughbred broodmares.

Cite This Article

APA
de Mestre AM, Rose BV, Chang YM, Wathes DC, Verheyen KLP. (2018). Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares. Theriogenology, 124, 18-23. https://doi.org/10.1016/j.theriogenology.2018.10.008

Publication

Theriogenology
ISSN: 1879-3231
NlmUniqueID: 0421510
Country: United States
Language: English
Volume: 124
Pages: 18-23
PII: S0093-691X(18)30920-8

Researcher Affiliations

de Mestre, A M
  • Department of Comparative Biomedical Sciences, The Royal Veterinary College, Hawkshead Lane, Herts, AL9 7TA, United Kingdom. Electronic address: ademestre@rvc.ac.uk.
Rose, B V
  • Department of Comparative Biomedical Sciences, The Royal Veterinary College, Hawkshead Lane, Herts, AL9 7TA, United Kingdom.
Chang, Y M
  • Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Herts, AL9 7TA, United Kingdom.
Wathes, D C
  • Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Herts, AL9 7TA, United Kingdom.
Verheyen, K L P
  • Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Herts, AL9 7TA, United Kingdom.

MeSH Terms

  • Abortion, Veterinary
  • Animals
  • Cohort Studies
  • Female
  • Horse Diseases / etiology
  • Horses
  • Logistic Models
  • Multivariate Analysis
  • Pregnancy
  • Pregnancy, Animal
  • Prospective Studies
  • Risk Factors

Citations

This article has been cited 12 times.
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