Perinatal outcomes of women with a prior history of unexplained recurrent miscarriage

Dempsey, Mark; Flood, Karen; Burke, Naomi; Fletcher, Patricia; Kirkham, Colin; Geary, Michael; Malone, Fergal D.

doi:10.3109/14767058.2014.923394

Cited by 19 publications

(24 citation statements)

References 15 publications

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“…There could be shared underlying risk factors for miscarriage and other adverse pregnancy outcomes. Several studies have looked at the association between the history of miscarriages and the future risk of other pregnancy complications,121314151617 but less is known about how complications might predict the future risk of miscarriage 181920…”

Section: Introductionmentioning

confidence: 99%

Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study

Magnus

Wilcox

Morken

et al. 2019

BMJ

409

227

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Objectives To estimate the burden of miscarriage in the Norwegian population and to evaluate the associations with maternal age and pregnancy history. Design Prospective register based study. Setting Medical Birth Register of Norway, the Norwegian Patient Register, and the induced abortion register. Participants All Norwegian women that were pregnant between 2009-13. Main outcome measure Risk of miscarriage according to the woman’s age and pregnancy history estimated by logistic regression. Results There were 421 201 pregnancies during the study period. The risk of miscarriage was lowest in women aged 25-29 (10%), and rose rapidly after age 30, reaching 53% in women aged 45 and over. There was a strong recurrence risk of miscarriage, with age adjusted odds ratios of 1.54 (95% confidence interval 1.48 to 1.60) after one miscarriage, 2.21 (2.03 to 2.41) after two, and 3.97 (3.29 to 4.78) after three consecutive miscarriages. The risk of miscarriage was modestly increased if the previous birth ended in a preterm delivery (adjusted odds ratio 1.22, 95% confidence interval 1.12 to 1.29), stillbirth (1.30, 1.11 to 1.53), caesarean section (1.16, 1.12 to 1.21), or if the woman had gestational diabetes in the previous pregnancy (1.19, 1.05 to 1.36). The risk of miscarriage was slightly higher in women who themselves had been small for gestational age (1.08, 1.04 to 1.13). Conclusions The risk of miscarriage varies greatly with maternal age, shows a strong pattern of recurrence, and is also increased after some adverse pregnancy outcomes. Miscarriage and other pregnancy complications might share underlying causes, which could be biological conditions or unmeasured common risk factors.

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Section: Introductionmentioning

confidence: 99%

Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study

Magnus

Wilcox

Morken

et al. 2019

BMJ

409

227

View full text Add to dashboard Cite

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“…This observation suggests that the number of miscarriages—a likely indicator of the gravity of the condition—is a major determinant of the reproductive success of women with RPL; in fact, it has been reported that the live birth rates in the successive pregnancy in women with two consecutive losses is around 75% [ 4 , 5 ]. On the other hand, several studies and reviews investigating the outcome of the successive pregnancy in women with RPL found that it was burdened by many obstetric and perinatal complications which occurred more frequently than in normal control women without RPL [ 6 , 7 , 8 , 9 ], even though this finding has not been observed in all studies [ 10 ]. Therefore, it is difficult for the clinicians to ensure a clear counseling, in terms of prognosis, to women with RPL about the subsequent pregnancy once the diagnostic workup has been completed.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy-Related Complications in Women with Recurrent Pregnancy Loss: A Prospective Cohort Study

Ticconi

Pietropolli

Specchia

et al. 2020

JCM

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The aim of this prospective cohort study was to determine whether women with recurrent pregnancy loss (RPL) have an increased risk of pregnancy complications compared to normal pregnant women. A total of 1092 singleton pregnancies were followed, 431 in women with RPL and 661 in normal healthy women. The prevalence of the following complications was observed: threatened miscarriage, miscarriage, cervical insufficiency, chromosomal/genetic abnormalities, fetal anomalies, oligohydramnios, polyhydramnios, fetal growth restriction, intrauterine fetal death, gestational diabetes mellitus (GDM), preeclampsia, placenta previa, abruptio placentae, pregnancy-related liver disorders, and preterm premature rupture of the membranes. The odds ratio and 95% CI for each pregnancy complication considered were determined by comparing women with RPL and normal healthy women. Women with RPL had an overall rate of pregnancy complications higher than normal women (OR = 4.37; 95% CI: 3.353–5.714; p < 0.0001). Their risk was increased for nearly all the conditions considered. They also had an increased risk of multiple concomitant pregnancy complications (OR = 4.64; 95% CI: 3.10–6.94, p < 0.0001). Considering only women with RPL, women with ≥3 losses had a higher risk of pregnancy complications than women with two losses (OR = 1.269; 95% CI: 1.112–2.386, p < 0.02). No differences were found in the overall risk of pregnancy complications according to the type, explained or unexplained, of RPL. Women with secondary RPL had an increased risk of GDM than women with primary RPL. Pregnancy in women with RPL should be considered at high risk.

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“…Approximately 15% of pregnant women experience spontaneous loss of a clinically recognized pregnancy. About 1–2% of couples trying to conceive are confronted with recurrent miscarriage (RM), which is defined as three or more consecutive miscarriages before the 20th week of gestation . Several factors influence the risk of miscarriage such as maternal age and previous pregnancy loss.…”

Section: Introductionmentioning

confidence: 99%

“…Several factors influence the risk of miscarriage such as maternal age and previous pregnancy loss. The major known causes include antiphospholipid syndrome, abnormal parental karyotype, endocrine disorders and uterine anomalies . However, the cause of RM can only be determined in half of the patients.…”

Section: Introductionmentioning

confidence: 99%

What is wrong with the regulatory T cells and foetomaternal tolerance in women with recurrent miscarriages?

Craenmehr

Heidt

Eikmans

et al. 2016

HLA

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Couples of whom the woman has had a miscarriage have two major concerns: the cause and possible risk of recurrence. Unfortunately, a significant proportion of cases of recurrent miscarriage (RM) remain unexplained despite detailed investigation. Because data suggest that regulatory T cells (Treg) are involved in the maternal acceptance of the allogeneic foetus, RM could possibly be explained by a disturbance of the Treg network. The possible role of Tregs in RM is described in this review, as well as their potential application in diagnostics and therapeutic intervention trials.

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Perinatal outcomes of women with a prior history of unexplained recurrent miscarriage

Abstract: Our study confirms the reassuring prognosis for achieving a live birth in the unexplained RM population with a very low incidence of adverse events with the majority delivering appropriately grown fetuses at term.

Cited by 19 publications

References 15 publications

Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study

Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study

Pregnancy-Related Complications in Women with Recurrent Pregnancy Loss: A Prospective Cohort Study

What is wrong with the regulatory T cells and foetomaternal tolerance in women with recurrent miscarriages?

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