# Conception Failure and Pregnancy Loss in the U.S.

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2020 · $315,760

## Abstract

NEW EVIDENCE ON CONCEPTION AND PREGNANCY LOSS IN THE U.S.
ABSTRACT
Conception failure and pregnancy loss impede the pathway to parenthood for millions of US couples each
year. Despite being modifiable and common—pregnancy loss occurs fifty times as often as infant mortality—
miscarriage is among the least well-studied aspects of population health or population dynamics. We know
little about what causes these losses, the generalizability of estimates generated from the study of small
recruited samples, including how the risk of miscarriage differs across time, place, or subpopulation.
 These enormous gaps are driven by how difficult it is to study the pathway to live birth in humans, requiring
a sufficiently large and diverse “preconception cohort.” To date small, nonrepresentative cohorts contribute
most of what we know about early pregnancy. But limited sample size, variation, and coverage preclude the
study of social and ecological factors—poverty, partner health, environmental exposures—that are now widely
understood to shape mortality at later ages: e.g., stillbirth, infant, and child mortality. Such omissions are
consequential. Conception failures and pregnancy loss have significant emotional and economic costs. Though
pregnancy failures are likely distributed unevenly across populations, the size of this disparate burden is
unknown. We do not have evidence about the potential impact of policies on the prevention of these outcomes.
 Our research combines the tools of data science and social science to scale the preconception design to a
large, diverse cohort in the US. Period and pregnancy “tracking” on digital devices is now common among
reproductive-age women. We use data on 4 million women’s day-to-day recording of menstrual cycles,
ovulation, and pregnancy, as well as reported social and economic characteristics. The data allow us to
measure both reported and detected conception and pregnancy loss. We combine the data with georeferenced
information about the physical, social, economic, and policy environments in which women and their partners
live. The sample is diverse: users come from over 99% of U.S. counties; over 1 million users are on Medicaid.
We use these extraordinary data to provide the first estimates of large-scale population variability in
the pathway to live birth and to document factors that affect this pathway. Aim 1 develops new estimates
of conception and pregnancy loss, including disparities associated with education, income, racial identification,
and neighborhood poverty. Aim 2 estimates the contribution of male partner characteristics to conception and
pregnancy loss, drawing on detailed data reported about partners. Aim 3 uses quasi-experimental designs to
provide the first estimates of understudied exposures from multiple environmental, social, economic domains
on conception and pregnancy loss. The research sheds new light on a pervasive and massively understudied
public health concern, with direct implications fo...

## Key facts

- **NIH application ID:** 9998409
- **Project number:** 1R01HD102207-01
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** JENNA E. NOBLES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $315,760
- **Award type:** 1
- **Project period:** 2020-04-15 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9998409

## Citation

> US National Institutes of Health, RePORTER application 9998409, Conception Failure and Pregnancy Loss in the U.S. (1R01HD102207-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9998409. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*