Prognosis of a new pregnancy following previous spontaneous abortions (original) (raw)
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.
Exploring the complexities of recurrent spontaneous abortion: An overview of contributing factors
World Journal of Advanced Research and Reviews, 2025
Background Recurrent spontaneous abortion (RSA), defined as two or more consecutive pregnancy losses, is a distressing condition affecting 1-3% of reproductive-age couples. The aetiology of RSA is multifactorial, incorporating genetic, anatomical, hormonal, immunological, and environmental factors. Despite advances in reproductive medicine, over 50% of cases remain unexplained, highlighting the complexities involved in diagnosis and treatment. Objective This review aims to provide an overview of the contributing factors to RSA, evaluate its physiological mechanisms, and identify gaps in current knowledge and practice. By examining both established and emerging causes of recurrent pregnancy loss, the review seeks to guide future research directions and inform clinical management strategies. Conclusion RSA presents significant emotional and physical challenges for affected individuals and couples. A comprehensive understanding of its multifactorial nature is essential for effective diagnosis and management. Enhanced awareness of risk factors such as thrombophilia's and chromosomal abnormalities is critical in developing targeted treatment approaches. Future research should focus on elucidating the genetic and environmental interactions that contribute to RSA, ultimately leading to improved patient outcomes and support.
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...
Multiple induced abortions: Danish experience
Patient Education and Counseling, 1997
Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family considerations). Though similar to first and second time aborters in their life situations and greater contraceptive risk-taking, third timers seemed to become pregnant more readily. They were also less willing to be interviewed. Related studies and suggestions for postabortion counseling are discussed.
Is induced abortion a risk factor in subsequent pregnancy?
Journal of Perinatal Medicine, 2000
Objective: To determine whether a history of terminations of pregnancy influences subsequent pregnancies in terms of pregnancy risks, prematurity and neonatal biometrics. Patients and methods: Based on the perinatal statistics of eight German federal states, data of 247,593 primiparous women with singleton pregnancies born between 1998 and 2000 were analyzed. The control group consisted of primiparous women without previous induced abortions. Maternal age was adjusted for. Results: There was an overall trend towards an increased rate of preterm delivery at F36 weeks' gestation and early preterm delivery at F31 weeks' gestation in women who had previous pregnancy terminations. For the cohort of 28-30 years, the observed rates of prematurity in women with one and with G2 previous induced abortions were 7.8% and 8.5%, respectively, compared to 6.5% in the control population (Ps0.015). Preceding terminations of pregnancy did not alter the rate of small-for-gestational-age newborns. Psychosocial stress and symptoms associated with prematurity such as cervical incompetence and vaginal bleeding before and after 28 weeks of gestation occurred more frequently in women with previous induced abortion compared to the control group (P-0.0001). Conclusion: The rate of preterm births increases with the number of preceding abortions. Similarly, symptoms
An update in recurrent spontaneous abortion
Archives of Gynecology and Obstetrics, 2005
Recurrent spontaneous abortion (RSA) is defined as three or more consecutive pregnancy losses prior to the 20th week of gestation. The etiology of recurrent spontaneous abortion is often unclear and may be multifactorial, with much controversy regarding diagnosis and treatment. Reasonably accepted etiologic causes include, genetics, anatomical, endocrine, placental anomalies, hormonal problems, infection, smoking and alcohol consumption, exposure to environmental factors, psychological trauma and stressful life event, certain coagulation and immunoregulatory protein defects. Detection of an abnormality in any of these areas may result into specific therapeutic measures, with varying degrees of success. However, the majority of cases of RSA remains unexplained and is found to be associated with certain autoimmune (APA, ANA, ACA, ATA, AECA) and alloimmune (APCA, Ab2, MLR-Bf) antibodies that may play major role in the immunologic failure of pregnancy and may lead to abortion. Alteration in the expression of HLA-G molecules, T-helper-1 (Th-1) pattern of cytokines and natural killer (NK) cells activity may also induce abortion. Various forms of treatment like antithrombotic therapies such as aspirin and heparin, intravenous immunoglobulin (IVIg) therapy, immunotherapy with paternal lymphocytes and vitamin D3 therapy are effective mode of treatment for unexplained cause of fetal loss in women with RSA.