Maternal Factors Associated With Fetal Chromosomal Anomalies in Spontaneous Abortions

Alberman, Eva; Creasy, M. R.; Elliott, M.; Spicer, C. C.

doi:10.1111/j.1471-0528.1976.tb00899.x

Cited by 64 publications

(16 citation statements)

References 12 publications

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“…It has recently been shown that women whose husbands had azoospermia and who had received artificial insemination with donor semen (AID) had a significant decline in fecundity after the age of 35 years (51-53). The rate of spontaneous abortion also increases with maternal age (53), probably due to an increased frequency of chromosomal abnormalities (54,55). The percentage of fetuses with chromosomal anomalies is double in women over 40 in comparison to women under 20.…”

Section: Age and Fertilitymentioning

confidence: 88%

Environment, human reproduction, menopause, and andropause.

Vermeulen¹

1993

Environ Health Perspect

105

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As the hypothalamic gonadotropin-releasing hormone (GnRH) pulse generator is an integrator of hormonal, metabolic, and neural signals, it is not surprising that the function of the hypothalamogonadal axis is subject to the influence of a large array of environmental factors. Before puberty, the central nervous system (CNS) restrains the GnRH pulse generator. Undernutrition, low socioeconomic status, stress, and emotional deprivation, all delay puberty. During reproductive life, among peripheral factors that effect the reproductive system, stress plays an important role. Stress, via the release of corticotropin-releasing factor (CRF), eventually triggered by interleukin 1, inhibits GnRH release, resulting in hypogonadism. Effects of CRF are probably mediated by the opioid system. Food restriction and underweight (anorexia nervosa), obesity, smoking, and alcohol all have negative effects on the GnRH pulse generator and gonadal function. Age and diet are important determinants of fertility in both men and women. The age-associated decrease in fertility in women has as a major determinant chromosomal abnormalities of the oocyte, with uterine factors playing a subsidiary role. Age at menopause, determined by ovarian oocyte depletion, is influenced by occupation, age at menarche, parity, age at last pregnancy, altitude, smoking, and use of oral contraceptives. Smoking, however, appears to be the major determinant. Premature menopause is most frequently attributable to mosaicism for Tlurner Syndrome, mumps ovaritis, and, above all, total hysterectomy, which has a prevalence of about 12-15% in women 50 years old. Premature ovarian failure with presence of immature follicles is most frequently caused by autoimmune diseases or is the consequence of irradiation or chemotherapy with alkylating cytostatics. Plasma estrogens have a physiological role in the prevention of osteoporosis. Obese women have osteoporosis less frequently than women who are not overweight. Early menopause, suppression of adrenal function (corticoids), and thyroid hormone treatment all increase the frequency of osteoporosis.Aging in men is accompanied by decreased Leydig cell and Sertoli cell function, which has a predominantly primary testicular origin, although changes also occur at the hypothalamopituitary level. Plasma testosterone levels, sperm production, and sperm quality decrease, but fertility, although declining, is preserved until senescence. Stress and disease states accelerate the decline on Leydig cell function. Many occupational noxious agents have a negative effect on fertility. There is evidence for a decline of sperm quality in the general male population over the last two decades, probably a consequence of increasing pollution, irradiation, and population stress. If the evidence is confirmed, it might be mandatory to reduce drastically pollution, irradiation, and other noxious agents that may impair spermatogenesis.

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Section: Age and Fertilitymentioning

confidence: 88%

Environment, human reproduction, menopause, and andropause.

Vermeulen¹

1993

Environ Health Perspect

105

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“…The effect seemed dose-dependent. Alberman et al [1976] also reported that smokers showed a higher, albeit not significantly higher, proportion of abortuses with normal chromosomes. This suggests that smoking affects the conceptus directly.…”

Section: Cigarette Smokingmentioning

confidence: 92%

Incidence and timing of pregnancy losses: Relevance to evaluating safety of early prenatal diagnosis

Simpson

1990

Am. J. Med. Genet.

133

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Knowing the frequency and timing of pregnancy loss during normal gestation is integral to evaluating the safety of prenatal diagnostic techniques. That preclinical loss rates are high in humans has long been suspected, but in the past decade new data concerning these losses have become available. Cohort studies indicate that many women who show positive beta-HCG assays never show clinical evidence of pregnancy. Cytogenetic abnormalities have also recently been documented in 20% of ostensibly normal in vitro fertilization embryos. All the above are consistent with the sentinel studies of Hertig and Rock, who showed high frequencies of morphological abnormalities in preimplantation embryos. The frequency of fetal losses after clinical recognition of pregnancy is 12-15%; however, more sensitive (ultrasonographic) methods of detecting fetal demise now indicate that most clinically recognized pregnancies occur prior to 8-9 weeks, being retained in utero 2-3 weeks prior to expulsion. Loss rates are influenced by maternal age, smoking, alcohol, and other confounding variables that if not taken into account could yield spurious results concerning safety of prenatal diagnostic techniques. After 8 weeks gestation the likelihood of losing a viable pregnancy is only 3% and after 16 weeks only 1%.

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“…However, even this insignificant increase was due to monosomy X and structural abnormalities, and not polyploidy as Carr [50] had reported. Alberman et al [53] observed 32% abnormalities in 524 prior users, compared to 26% in 428 controls. Dhardial et al [54] found differences of a similar, but again insignificant, magnitude.…”

Section: Numerical Chromosomal Abnormalitiesmentioning

confidence: 94%

Relationship between congenital anomalies and contraception

1985

Adv Contracept

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Maternal Factors Associated With Fetal Chromosomal Anomalies in Spontaneous Abortions

Cited by 64 publications

References 12 publications

Environment, human reproduction, menopause, and andropause.

Environment, human reproduction, menopause, and andropause.

Incidence and timing of pregnancy losses: Relevance to evaluating safety of early prenatal diagnosis

Relationship between congenital anomalies and contraception

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