Maternal miscarriage history and risk of anencephaly

Abstract

Women with a history of reproductive loss may be at an increased risk of having an unfavourable outcome in subsequent pregnancies. Using data from a matched case-control study based on the record of the Epidemiological Surveillance System of Neural Tube Defects, we evaluated the association between history of maternal reproductive loss and the risk of anencephaly in three Mexican states. Mothers of 157 cases of anencephaly and 151 controls born during the period March 2000 to February 2001, were interviewed about their reproductive history and other additional factors, including socio-economic characteristics, prenatal care, use of tobacco and alcohol, presence of chronic diseases, acute illnesses and fever during the periconceptional period, and consumption of multivitamins and medicines during this period; mothers who reported no prior pregnancies were excluded from the analysis; 58 matched case-control pairs were used for the analysis. After adjusting for potential confounders, women with a history of miscarriage in previous pregnancies had 4.58 times more risk of having a child with anencephaly, than those who did not have this history; OR = 4.58, [95% CI 1.22, 17.23]. Our results suggest that a history of previous miscarriages is a risk indicator for anencephaly in future gestations. This does not necessarily mean that the miscarriage itself is the cause, but that common mechanisms could be involved in the aetiology of both events. Thus, women who have had histories of reproductive losses, especially miscarriages, should be a priority group for the primary and secondary prevention of neural tube defects.

Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis

“…Jia, et al International Journal of Developmental Neuroscience 78 (2019) 227-235 Abbreviations: OR/RR, odds ratio/relative ratio; LL, low limit of 95%CI; UL, upper limit of 95%CI; NR, not report. Marco et al (2011) 38/ 144 Lu et al (2011) 86/153 Yin et al (2011) 78/131 Blanco-Munoz et al (2006) 17/21 Todoroff and Shaw (2000) 122/271 Canfield et al (1996) 27/118 Kurinczuk and Clarke (1993) 6 Grewal et al (2009) 112/269 Li et al (2006) 146/341 Mandiracioglu et al (2004) 40/99 Farley et al (2002) 28/93 Wasserman et al (1998) 204/353 Canfield et al (1996) 37/191 nausea and vomiting during the first trimester of pregnancy Zhang et al (2018) 258/832 1.48[0.73-3.00] 0.274 < 0.001 Lu et al (2015) 53/81 Anderka et al (2012) NR Czeizel et al (2006) 97/3874 pregestational diabetes Garne et al (2012) 41/NR 2.24[1.21-4.12] 0.01 0.043 Macintosh et al (2006) 10/2400 Anderson et al (2005) 10/13 Ray et al (2004) 4/2069 Janssen et al (1996) 2/1511 hazardous waste sites Suarez et al (2007) 20/137 1.10[0.89-1.37] 0.381 0.061 Morris et al (2003) 14/149 Elliott et al (2001) 3508/4648 Dolk et al (1998) 130/NR Croen et al (1997) Gu et al (2007) 68/2829 Nili and Jahangiri (2006) 147/238 Farley et al (2002) 129/589 birth season Gu et al (2007) 66/3075 1.11[0.99-1.25] 0.071 0.54 Nili and Jahangiri (2006) 132/228…”

Is maternal parity an independent risk factor for birth defects?

“…We were particularly interested in assessing the possibility of confounding from history of fetal loss, fertility treatment, and gestational hypertension, because each of these factors have been shown to be associated with both parity and birth defects (Gunnlaugsson et al, 1989; Bergh et al, 1999; Strevens et al, 2001; Blanco‐Munoz et al, 2006; Zhu et al, 2006; Caton et al, 2008, 2009; Reefhuis et al, 2009; Lebby et al, 2010). After adjusting for these factors and other covariates, the magnitude and significance of the ORs between nulliparity and birth defects remained the same.…”

“…In particular, previous studies did not adjust for maternal infertility, gestational hypertension or a history of previous fetal loss. Each of these factors has been observed to be associated with some types of birth defects (Bergh et al, 1999; Blanco‐Munoz et al, 2006; Zhu et al, 2006; Caton et al, 2008, 2009; Reefhuis et al, 2009; Lebby et al, 2010) and may also be associated with parity (Gunnlaugsson et al, 1989; Strevens et al, 2001). This paper examines the association of different levels of parity with 17 phenotypes of noncardiac defects and 21 phenotypes and subphenotypes of cardiac defects, while adjusting for a wider range of confounding variables than previous studies.…”

Inclusion of Body Mass Index in the History of Present Illness

“…Table 1 describes the most frequent adverse obstetric outcomes or conditions and their association with the various descriptors, including maternal age, gravidity, parity, history of preterm delivery, history of abortions, race and ethnicity, and prepregnancy BMI. Of the 34 listed adverse obstetric outcomes or conditions, maternal age was linked to 20 (59%), [3][4][5][6][7][8][9][10][11][12][13][14][15] gravidity was linked to 11 (32%), 10,12,13,[16][17][18][19][20][21] parity was linked to 14 (41%), [10][11][12]14,18,19,22 history of preterm birth was linked to 18 (53%), 9,20,22,23 history of abortions was linked to 8 (24%), 17,19-21 and race and ethnicity were linked to 17 (50%). 15,[23][24][25][26][27] As shown in Table 3, BMI had the strongest association (32 [94%]) with adverse pregnancy outcomes or conditions.…”