Prognosis of a new pregnancy following previous spontaneous abortions (original) (raw)
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Validation of spontaneous abortion diagnoses in the Danish National Registry of Patients
Clinical Epidemiology, 2010
The purpose of this study is to validate the diagnosis of spontaneous abortion (SA) recorded in the Danish National Registry of Patients (DNRP). Methods: We randomly selected patients registered in the DNRP with a diagnosis of SA between 1980 and 2008 from hospitals in the county of North Jutland and searched for their discharge records in hospital files. We estimated positive predictive value (PPV) of the DNRP diagnosis and stratified the analysis by period (1980-1994 versus 1995-2008), hospital type (regional versus local), and International Classification of Diseases revisions (ICD-8 versus ICD-10). Results: We could identify hospital files of 117/174 (67%) sampled registration records. Of those, the diagnosis was confirmed in 114 patients, yielding a PPV of 97.4% (95% confidence interval = 92.7%-99.5%). The PPV did not markedly vary by period, hospital type, or ICD revision. Among the three patients with available data who did not fulfill the criteria for SA, one had an induced abortion and two had threatened abortion but did not miscarry. Conclusion: Registration of SA in the DNRP accurately reflects the diagnoses recorded in medical charts. The DNRP is a suitable source of data on SAs for epidemiologic research.
Spontaneous and Induced Abortions and Its Determinants in Women Aged 15-49
2021
Aim: Abortions, which are among the causes of maternal mortality in the world, continue to be important not only for women's health, but also because they have devastating physiological, psychological, and economic effects on the family and society. The present study aimed to determine the prevalence of total, induced, and spontaneous abortion in women aged 15-49 in a Family Health Center (FHC) region, and the factors affecting the abortion prevalence. Methods: This cross-sectional study was conducted with 311 women aged 15-49 registered between February and December 2017 at the FHC region in Northwest Thrace in Turkey. Results: The unintended pregnancy prevalence of the participants was 14.8%, and abortion prevalence was 22.2%. Spontaneous and induced abortions prevalence was 12.2% and 10.9%, respectively. According to the multivariate logistic regression analysis, the likelihood of abortion was significantly higher than the reference category in those who perceived their income at a bad level, current smokers, and those who considered abortion as a family planning method used to avoid unwanted pregnancies (p <0.05). The likelihood of induced abortion was significantly higher in women who perceived their income at a bad level, those with spouses aged 35 and older, and those whose spouses had primary school and lower levels of education (p<0.05). The likelihood of spontaneous abortion in women was higher in each one-unit increase in the total number of pregnancies, compared to those with high-school education, and those who perceived their income at a bad level (p<0.05). Conclusion: Nearly one out of every five women had undesired pregnancy experience, and one out of every four women had abortion experience. Spontaneous abortion prevalence was higher than that of induced abortion. Some sociodemographic and/ or obstetric characteristics are determinants of total abortion, induced abortion, and spontaneous abortion.
Spontaneous abortion and subsequent adverse birth outcomes
American Journal of Obstetrics and Gynecology, 1992
Seattle, Wa.lhlllgtOIl OBJECTIVE: Our purpose was to evaluate the association between spontaneous abortion and subsequent adverse birth outcomes. STUDY DESIGN: Washington State birth certificate records for 1984 to 1987 were used to examine the association between spontaneous abortion and adverse outcomes in the subsequent live birth. Adverse birth outcomes were examined for women with one spontaneous abortion before the Index pregnancy (n = 2146) and for women with three or more prior spontaneous abortions and no other prior pregnancies (n = 638); compared with women with no prior spontaneous abortions (n = 3099). Logistic regression was used to estimate the relative risk associated with prior spontaneous abortion of each adverse outcome. RESULTS: Women with three or more prior spontaneous abortions were at higher risk for delivery at < 37 weeks' gestation (relative risk 1.5, 95% confidence interval 1.1 to 2 .1), placenta previa (relative risk 6.0, 95% confidence interval 1.6 to 22.2), haVing membranes ruptured > 24 hours (relative risk 1.8, 95% confidence interval 1.2 to 2.9), breech presentation (relative risk 2.4, 95% confidence Interval 1.6 to 3.6), and having an infant With a congel1ltal malformation (relative risk 1.8, 95% confidence Interval 1.1 to 3.0). CONCLUSION: These findings suggest that common causes may underlie recurrent spontaneous abortion and certain adverse birth outcomes. They may also help guide clinical management of pregnancies in women with a history of recurrent spontaneous abortions.
American Journal of Public Health, 1986
Women with a history of recurrent spontaneous abortions (repeaters) are compared with women who have had live births and no spontaneous abortions (multiparae) and women who have had live births and only one spontaneous abortion (sporadics) to identify characteristics of the women and their abortuses that might predict subsequent fetal loss. A number of risk factors for recurrent spontaneous abortion have been identified: the loss of a chromosomally normal conception, loss after the first trimester of pregnancy, a delay in conceiving prior to the study pregnancy, a diagnosis of cervical incompetence, and a history of very low birthweight deliveries. The odds ratios associated with being a repeater vary from 1.4 to 5.6 depending on the number of characteristics present.
Risk Factors for Spontaneous Abortion
International Journal of Epidemiology, 1991
A case-control study was conducted to evaluate risk factors for spontaneous abortions. Cases were 94 women with two or more unexplained miscarriages (after exclusion of genetic, endocrine and Mullerian factors) and no term pregnancy, controls were 176 women admitted for normal delivery to the same clinic where cases were identified. Questions were asked about personal characteristics and habits, and gynaecological history. A family history of recurrent miscarriage was more common among women with spontaneous miscarriages than among the controls (13 cases versus 8 controls, relative risk(RR) =3.2, 95% confidence interval (CD = 1.3-8.1). Compared to women whose menarche occurred at age 11 or younger, the RRs were 0.8 when menarche occurred at age 12-13 and 0.5 at age 14 or more: this trend in risk was statistically significant. Compared with never smokers, current smokers had about a 40% increased risk of miscarriage and the risk increased with number of cigarettes per day. No association emerged with sociodemographic characteristics (e.g. education, marital status, age of the partner), reproductive history (age at first pregnancy), type of contraceptive used and other general lifestyle habits (e.g. alcohol or coffee consumption).
Pregnancy outcome following recurrent spontaneous abortions
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2005
Objective: The purpose of the present study was to examine the association between spontaneous consecutive recurrent abortions and pregnancy complications such as hypertensive disorders, abruptio placenta, intrauterine growth restriction and cesarean section (CS) in the subsequent pregnancy. Methods: A population-based study comparing all singleton pregnancies in women with and without two or more consecutive recurrent abortions was conducted. Deliveries occurred during the years 1988-2002. Stratified analysis, using a multiple logistic regression model was performed to control for confounders. Results: During the study period 154,294 singleton deliveries occurred, with 4.9% in patients with history of recurrent consecutive abortions. Using a multivariate analysis, with backward elimination, the following complications were significantly associated with recurrent abortions-advanced maternal age, cervical incompetence, previous CS, diabetes mellitus, hypertensive disorders, placenta previa and abruptio placenta, mal-presentations and PROM. A higher rate of CS was found among patients with previous spontaneous consecutive recurrent abortions (15.9% versus 10.9%; OR = 1.6; 95% CI, 1.5-1.7; P < 0.001). Another multivariate analysis was performed, with CS as the outcome variable, controlling for confounders such as placenta previa, abruptio placenta, diabetes mellitus, hypertensive disorders, previous CS, mal-presentations, fertility treatments and PROM. A history of recurrent abortion was found as an independent risk factor for CS (OR = 1.2; 95% CI, 1.1-1.3; P < 0.001). About 58 cases of inherited thrombophilia were found between the years 2000-2002. These cases were significantly more common in the recurrent abortion as compared to the comparison group (1.2% versus 0.1%; OR = 11.1; 95% CI, 6.5-18.9; P < 0.001). Conclusion: A significant association exists between consecutive recurrent abortions and pregnancy complications such as placental abruption, hypertensive disorders and CS. This association persists after controlling for variables considered to coexist with recurrent abortions. Careful surveillance is required in pregnancies following recurrent abortions, for early detection of possible complications.
International journal of reproduction, contraception, obstetrics and gynecology, 2023
Background: Majority of spontaneous pregnancy loss occur in early gestation. Early pregnancy loss causes great physical and psychological distress to couples and creates apprehension in achieving future reproductive success. Previous abortions have a definite impact on the successful outcome of future pregnancies. Hence for such pregnancies careful antenatal care is mandatory. Careful surveillances required in pregnancies preceded by spontaneous abortions, for early detection of possible complications. Methods: This was a prospective observational comparative study conducted on 184 antenatal women (92 patients with previous spontaneous abortion, no full-term delivery, selected as cases while 92 patients with previous full term normal vaginal delivery with no previous abortion selected as control) attending antenatal OPD at Holy Family Hospital, New Delhi, from October 2020 to May 2022. All women received regular antenatal care and were followed up till delivery for maternal and foetal outcome. Results: For predicting pregnancy outcome following previous spontaneous abortion showed statistically significant in term of obesity, 56.52% patients were obese in cases while in controls only 48.91%. Duration of marriage, in cases is 2.22 years, where as in controls were 4.24 years with significant result. Interpregnancy interval (months) in cases was 10.58±4.19 whereas in controls it was 32.53±14.41 with significant result. Antenatal complications in term of GDM, hypothyroidism, IUGR more in cases than controls. Conclusions: We found that prior spontaneous abortion miscarriage is definitely a risk factor for the next pregnancy, making present pregnancy a high-risk pregnancy.
Characteristics of Recurrent Spontaneous Abortion in Al-Jumhouria Hospital Benghazi 2020
Asian Journal of Basic Science & Research , 2024
Background: Recurrent spontaneous abortion defined as three or more consecutive pregnancy loss before 24 weeks is a challenge for gynecologists because of the complex and variable etiologies behind. Exploring characteristics of patients with this condition may help researchers and clinicians. Therefore, the aim of the present work was to outline the demographic and patient history wise factors related to RSA and to analyze the association of those factors with occurrence of RSA. Methods: Case control study included cases collected from Benghazi medical center from records of deliveries January 2020 to December 2020. Statistical analysis was executed using SPSS 23.0. Results: A total of 250 cases were investigated. Among those 30 cases met the definition of RSA. The rate of explained abortion among subset with spontaneous abortion was only 10.0%. The rate of advanced maternal age among the study population was 29.2%. The rate of RSA was higher among mothers with advanced maternal age (15.1% for 10.7%). This difference was statistically insignificant (P=0.338). The history of abortion among the study population showed a rate of first trimester abortion was 36.8% and second trimester abortion as 4.8%. RSA rate was much higher among mothers with history of 1st trimester abortion (20.7% for 7.0%) with statistically significant association (P<0.001) and OR of 3.5 (95% CI; 1.6–7.7). In multivariate analysis the history of 1st trimester abortion was an independent predictor for RSA. Also, in multivariate analysis, secondary infertility was independent negative predictor for RSA, (P=0.034 and OR=0.18; 95% CI: 0.04–0.88). The rates of bad obstetric history, HDP, GDM, any medical condition and history of low vitamin D3 were 15.2%, 17.2%, 8.8%, 16.8% and 19.2%; respectively among the study population. Mothers with bad obstetric history have a higher rate of RSA (18.4% for 10.8%), but the difference is not statistically significant (P=0.183) No significant association between HDP, GDM, history for medical conditions or history of low serum vitamin D with RSA (P=0.934, 0.735, 0.308 and 0.109 respectively). Conclusion: Recurrent spontaneous abortion is under-investigated and seems to be more likely with first trimester abortion and it is may be associated with several factors like infertility and maternal age. Anyhow, those associations need to be verified. Considering early investigations for couples with spontaneous abortion within the first trimester and further well designed prospective study are recommended.
Lifetime Prevalence of Abortion and Risk Factors in Women: Evidence from a Cohort Study
Journal of Pregnancy
Background. 10-20% of pregnancies end due to spontaneous abortions. In recent years, nondocumentary evidence has been indicative of an increase in the prevalence of nonspontaneous abortions in Iran, especially in the Kurdish regions. The aim of this study is to assess the lifetime prevalence of spontaneous abortions and factors affecting spontaneous abortion in women 35-65 years old. Method. Data from the recruitment phase of Ravansar Non-Communicable Disease (RaNCD) cohort study was used. All of the 4831 married women 35-65 years old and with history of pregnancy were included in this study. In order to determine the abortion ratio, the number of abortions was divided by the number of live births, and multiple logistic regression analysis was applied to determine associated factors affecting abortion. Results. About 25.7% of women had a history of spontaneous abortion. The abortion ratio in women was 0.10. The abortion ratio in women with secondary education, first pregnancy and ma...