Pregnancy before recurrent pregnancy loss more often complicated by post‐term birth and perinatal death

Abstract

Introduction. The cause of recurrent pregnancy loss often remains unknown. Possibly, pathophysiological pathways are shared with other pregnancy complications. Material and methods. All women with secondary recurrent pregnancy loss (SRPL) visiting Leiden University Medical Center (January 2000(January -2015 were included in this retrospective cohort to assess whether women with SRPL have a more complicated first pregnancy compared with control women. SRPL was defined as three or more consecutive pregnancy losses before 22 weeks of gestation, with a previous birth. The control group consisted of all Dutch nullipara delivering a singleton (January 2000(January -2015. Information was obtained from the Dutch Perinatal Registry. Outcomes were preeclampsia, preterm birth, post-term birth, intrauterine growth restriction, breach position, induction of labor, cesarean section, congenital abnormalities, perinatal death and severe hemorrhage in the first ongoing pregnancy. Subgroup analyses were performed for women with idiopathic SRPL and for women ≤35 years. Results. In all, 172 women with SRPL and 1 196 178 control women were included. Women with SRPL were older and had a higher body mass index; 29.7 years vs. 28.8 years and 25.1 kg/m 2 vs. 24.1 kg/m 2 , respectively. Women with SRPL more often had a post-term birth (OR 1.86, 95% CI 1.10-3.17) and more perinatal deaths occurred in women with SRPL compared with the control group (OR 5.03,. Similar results were found in both subgroup analyses. Conclusions. The first ongoing pregnancy of women with (idiopathic) SRPL is more often complicated by post-term birth and perinatal death. Revealing possible links between SRPL and these pregnancy complications might lead to a better understanding of underlying pathophysiology.

Adverse outcomes in subsequent pregnancies in women with history of recurrent spontaneous abortion: A meta‐analysis

“…Four studies 11,26,35,38 investigated the association between a history of RSA and postpartum hemorrhage. The combined analysis result of the random‐effect model showed that there was no association between a history of RSA and postpartum hemorrhage ( I 2 = 89.3%, OR: 2.14, 95% CI: 0.94–4.88, p = 0.071).…”

“…A total of 57 titles and abstracts were read based on the inclusion and exclusion criteria. Finally, 15 studies [10][11][12][13]26,[29][30][31][32][33][34][35][36][37][38] were included in this meta-analysis. The literature search flow chart is shown in Figure 1.…”

“…Three studies 11,32,37 evaluated the association between a history of RSA and fetal anomalies. The association between a history of RSA and fetal anomalies was not observed (I 2 = 54.1%, OR: 1.38, 95% CI: 0.77-2.49, p = 0.281) (Table 2, Figure 10).…”

“…10 The first ongoing pregnancy of women with RSA was more often complicated by post-term birth and perinatal death. 11 History of spontaneous abortion and RSA were found to be associated with increased odds of preterm delivery. 12 However, a previous study reported that a history of RSA was not associated with an increased incidence of preterm birth.…”

High androgen level causes recurrent miscarriage and impairs endometrial receptivity

“…In addition, the risk of RM increases with successive pregnancy loss [10]. It has also been reported that risk factors for RM may be immunological, and may be associated with polycystic ovary apart from spontaneous abortions [11]. On the other hand, it has been reported that PCOS is a major factor responsible for high incidence of RM, and that the underlying causes of RM are genetic factors, as well as endocrine and autoimmune diseases [12].…”