Adverse pregnancy and perinatal outcome in patients with recurrent pregnancy loss: Multiple imputation analyses with propensity score adjustment applied to a large‐scale birth cohort of the Japan Environment and Children’s Study

Abstract

Problem Several studies have reported the increased risk of preterm birth, premature rupture of membranes, and low birth weight in patients with recurrent pregnancy loss (RPL). There have been a limited number of large population‐based studies examining adverse pregnancy and perinatal outcome after RPL. Multiple‐imputed analyses (MIA) adjusting for biases due to missing data is also lacking. Method of study A nationwide birth cohort study known as the “Japan Environment and Children’s Study (JECS)” was conducted by the Ministry of the Environment. The subjects consisted of 104 102 registered children (including fetuses or embryos). Results No increased risk of a congenital anomaly, aneuploidy, neonatal asphyxia, or a small for date infant was observed among the children from women with a history of RPL. A novel increased risk of placental adhesion and uterine infection was found. The adjusted ORs using MIA in women with three or more PL were 1.76 (95% CI, 1.04‐2.96) for a stillbirth, 1.68 (1.12‐2.52) for a pregnancy loss, 2.53 (1.17‐5.47) for placental adhesion, 1.87 (1.37‐2.55) and 1.60 (.99‐2.57) for mild and severe hypertensive disorders of pregnancy, respectively, 1.94 (1.06‐3.55) for uterine infection, 1.28 (1.11‐1.47) for caesarean section and .86 (.76‐.98) for a male infant. Conclusion MIA better quantified the risk, which could encourage women who might hesitate to attempt a subsequent pregnancy.

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

“…The risk of miscarriage increased by increasing the number of previous losses. The higher risk of fetal anomalies in women with RPL is in substantial accordance with the observations of previous studied carried out on this issue [ 24 , 25 ], even though other more recent studies could not find this association [ 8 , 26 ]. However, the postnatal genetic follow-up of the newborns was incomplete in our series and this limitation does not allows to draw firm conclusions on this issue.…”

“…However, several other studies could not demonstrate the above associations with RPL [26,28]. Similar considerations can be made for gestational diabetes mellitus, preeclampsia, placenta previa and abruptio placentae, conditions for which the association was either found to variable extent or not found at all [5][6][7][8][9][10]24,[26][27][28][29][30]. Pregnancy-related liver disorders were found to be more frequent in women with RPL than in control women.…”

“…These findings are in accordance, although to a variable extent, with many of the studied previously carried out [ 6 , 7 , 24 , 27 ]. However, several other studies could not demonstrate the above associations with RPL [ 26 , 28 ]. Similar considerations can be made for gestational diabetes mellitus, preeclampsia, placenta previa and abruptio placentae, conditions for which the association was either found to variable extent or not found at all [ 5 , 6 , 7 , 8 , 9 , 10 , 24 , 26 , 27 , 28 , 29 , 30 ].…”

Prevalence and Associated Factors of Perinatal Asphyxia in Neonates Admitted to Ayder Comprehensive Specialized Hospital, Northern Ethiopia: A Cross-Sectional Study

“…Anaerobic glycolysis and lactic acidosis will ensue. Neonatal hypoxic ischemic encephalopathy refers to the neurologic sequelae of perinatal asphyxia [2,3].…”

<p>Impact of Recurrent Miscarriage on Maternal Outcomes in Subsequent Pregnancy: The Mutaba’ah Study</p>

“…Similar associations were found using different RM definitions. 17,[25][26][27] Caregiver bias, where cesarean section is chosen as a simple mode of delivery in high-risk pregnancies, has been postulated to explain the increased likelihood of cesarean section in women with a history of RM. 25,28 On the other hand, it has been suggested that both pregnancy loss and preterm delivery may be due to genital infections.…”