Is the incidence of recurrent pregnancy loss increasing? A retrospective register‐based study in Sweden

Roepke, Emma Rasmark; Matthiesen, Leif; Rylance, Rebecca; Christiansen, Ole Bjarne

doi:10.1111/aogs.13210

Cited by 57 publications

(56 citation statements)

References 30 publications

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“…evaluated Swedish women who were pregnant between 2003 and 2012 and found a 58% increase in the number of new cases of RPL (three or more prior miscarriages) during this period. The authors suggested that this significant increase in the incidence is because of couples' decisions to conceive later in life and obesity …”

Section: Introductionmentioning

confidence: 99%

Obesity and recurrent miscarriage: A systematic review and meta‐analysis

Cavalcante

Sarno

Peixoto

et al. 2018

J of Obstet and Gynaecol

104

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The aim of this study is to perform a systematic review and meta-analysis on the relationship between excess weight and risk of recurrent pregnancy loss (RPL) and to highlight the common immunological mechanisms of these two conditions. The PubMed and MEDLINE databases were searched for publications in English available as of November 2017. The search terms used were 'recurrent pregnancy loss', 'body mass index' (BMI), 'overweight' and 'obesity'. For calculation of the odds ratio (OR) and 95% confidence intervals (CI) for miscarriage in different BMI groups, RevMan software was used (Review Manager, Version 5.3.5 for Windows; The Cochrane Collaboration). In total, 100 publications including the search terms were identified. Six studies were included for qualitative analysis, and two studies were included for quantitative analysis (meta-analysis). The association between excess weight and RPL was significant (OR, 1.34; 95% CI, 1.05-1.70; P = 0.02). The isolated analyses of the groups of obese and overweight women revealed an association only between obesity and RPL (OR, 1.75; 95% CI, 1.24-2.47; P = 0.001). The data available in the current literature revealed that obese women with a history of RPL have a high risk of future pregnancy losses, a risk which was not found among overweight women.

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Section: Introductionmentioning

confidence: 99%

Obesity and recurrent miscarriage: A systematic review and meta‐analysis

Cavalcante

Sarno

Peixoto

et al. 2018

J of Obstet and Gynaecol

104

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“…11 Two Scandinavian studies found that 40-48% of cases were secondary RPL. 1,12 One study from Israel reported that 61% of cases were secondary RPL. 13 RPL is a multifactorial condition that in addition to fetal causes have multiple known female risk factors such as autoimmune diseases, endocrine disorders, and uterine malformations.…”

Section: Introductionmentioning

confidence: 99%

A phenome-wide analysis of short- and long-run disease incidence following Recurrent Pregnancy Loss using data from a 39-year period

Westergaard

Nielsen

Mortensen

et al. 2019

Preprint

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Background: Pregnancy loss is one of the most frequent pregnancy complications. It is unclear how recurrent pregnancy loss (RPL) impacts disease risk later in life and if later disease risk is different in women with or without a live birth prior to RPL (primary vs. secondary RPL). We sought to investigate if women have an increased risk of disease following RPL, and if there was a difference between primary and secondary RPL. Methods: Using population-wide health care registry databases from Denmark we identified a cohort of 1,370,896 women between 12 and 40 years in the period January 1, 1977, to October 5, 2016 who had been pregnant. Each woman was followed on average for 15.8 years. Of these, 10,691 (0.77%) women fulfilled the criteria for RPL (50.0% had primary RPL). Relative Risk Ratios (RR) were calculated in a phenome-wide manner for diagnoses with a cumulative incidence proportion ≥0.1% in women with RPL. Diagnoses related to assessment and diagnosis of RPL and those appearing later in life were separated using a Mixture Model. Results: In the full cohort of pregnant women, 0.77% (10,691) fulfilled the criteria for RPL (50.0% primary RPL). Compared to women without RPL, primary RPL increased the risk of subsequent cardiovascular disorders, including atherosclerosis (RR=2.45, 1.65-3.51 95% Uncertainty Interval (UI)), cerebral infarction (RR=1.87, 1.43-2.4 95% UI), heart failure (RR=1.97, 1.44-2.63 95% UI), and pulmonary embolism (RR=1.82, 1.32-2.46 95% UI). Women with secondary RPL had an increased risk of obstetric complications, e.g. placenta previa (RR=3.76, 2.9-4.8 95% UI), premature rupture of membrane (RR=2.55, 2.21-2.91 95% UI), intrapartum hemorrhage (RR=2.8, 1.77-4.31 95% UI), gestational hypertension (RR=2.2, 1.67-2.87 95% UI), and puerperal sepsis (RR=2.54, 1.8-3.5 95% UI). We also noticed associations to autoimmune, respiratory, gastro-intestinal and mental disorders in both subtypes. Conclusion: Our findings show that RPL is a risk factor for a spectrum of disorders. This can in part be due to increased screening following RPL, but it also suggests that RPL may directly influence or share etiology with a number of diseases later in life. Research into the pathophysiology of both pregnancy loss and later diseases merits further investigation.

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“…The most appropriate definition of RPL is three or more consecutive miscarriages before gestational week 22 (gestational age 21 weeks +6 days) . According to this, the incidence of RPL is estimated to vary between 0.5 and 2.3% in different populations . However, some define RPL as two or more miscarriages .…”

Section: Introductionmentioning

confidence: 99%

Treatment efficacy for idiopathic recurrent pregnancy loss – a systematic review and meta‐analyses

Roepke

Hellgren

Hjertberg³

et al. 2018

Acta Obstet Gynecol Scand

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Is the incidence of recurrent pregnancy loss increasing? A retrospective register‐based study in Sweden

Abstract: This study suggests that the incidence of RPL increased during the 10-year period studied. Causes can only be speculated upon in this study design, but might be associated with environmental changes, as the increase was fairly rapid.

Cited by 57 publications

References 30 publications

Obesity and recurrent miscarriage: A systematic review and meta‐analysis

Obesity and recurrent miscarriage: A systematic review and meta‐analysis

A phenome-wide analysis of short- and long-run disease incidence following Recurrent Pregnancy Loss using data from a 39-year period

Treatment efficacy for idiopathic recurrent pregnancy loss – a systematic review and meta‐analyses

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