Miscarriage syndrome: Linking early pregnancy loss to obstetric and age-related disorders

Bortoletto, Pietro; Lucas, Emma S.; Melo, Pedro; Gallos, Ioannis; Devall, Adam J.; Bourne, T.; Quenby, Siobhán; Bennett, Phillip R.; Coomarasamy, Arri; Brosens, Jan J.

doi:10.1016/j.ebiom.2022.104134

Cited by 16 publications

(10 citation statements)

References 49 publications

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“…We further performed subgroup analyses on known risk factors for miscarriage, including age, 40,41 previous miscarriage, 4,42 and BMI. 43 Consistent with previous research, we found that women of advanced age (≥35 years) and those with a history of multiple miscarriages (≥3) had higher rates of miscarriage.…”

Section: Discussionmentioning

confidence: 99%

Preconception anti‐annexin A5 antibodies are associated with subsequent live birth in women with recurrent miscarriage: A retrospective study from China

Mu,

Wang,

Liu

et al. 2024

American J Rep Immunol

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ProblemTo evaluate the correlation between the antiannexin A5 antibodies (aAnxA5) multiples of median (MOM) and subsequent pregnancy outcomes in women with recurrent miscarriage (RM).MethodsTotally, 310 RM women were included in this study and grouped into tertiles according to their MOM of preconception aAnxA5 circulating levels determined by ELISA. The effect of aAnxA5 on the pregnancy outcomes was performed using multiple logistic regression. The outcomes included early miscarriage (before 10 weeks of gestation), late miscarriage (between 10 and 24 weeks), ongoing pregnancy (beyond 10 weeks), and live birth (after 24 weeks) characterized by pregnancy with fetal heartbeat.ResultsFor each unit increase in aAnxA5 MOM, the odds of live birth after 24 weeks and ongoing pregnancy were reduced by 40.2% (OR = .598; 95%CI 0.406–0.882, P = .010) and 38.1% (OR = .619; 95%CI 0.424–0.904, P = .013), respectively, after adjusting for demographic and clinical characteristics. The rise in aAnxA5 MOM was associated with an increased risk of early miscarriage (OR = 1.616; 95%CI 1.106–2.361, P = .013) and miscarriage (early + late miscarriage) (OR = 1.671; 95%CI 1.134–2.464, P = .010). Further subgroup analyses showed a decreased risk of live birth rates after 24 weeks of gestation in the two subgroups: maternal age ≥35 years (OR = .131; 95%CI 0.026–0.652), and previous pregnancy loss ≥ 3 (OR = .381; 95%CI 0.173–0.837).ConclusionsHigher preconception aAnxA5 MOM levels in women with RM may be linked with a decreased risk of live birth after 24 weeks and an increased risk of early miscarriage, especially in individuals aged ≥35 years or with previous pregnancy losses ≥3.

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Section: Discussionmentioning

confidence: 99%

Preconception anti‐annexin A5 antibodies are associated with subsequent live birth in women with recurrent miscarriage: A retrospective study from China

Mu,

Wang,

Liu

et al. 2024

American J Rep Immunol

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“…Strikingly, mosaicism tended to be higher in extra-embryonic mesoderm relative to chorionic villi, which again suggests persistent involvement of abnormal fetal cells in pregnancy loss. Over 90% of pregnancy losses occur during the first trimester 37 , 38 . Chromosomal abnormalities in the fetus are recognized as a primary cause of pregnancy loss.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of chromosomal alterations in first-trimester spontaneous pregnancy loss

Essers,

Lebedev,

Kurg

et al. 2023

Nat Med

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Pregnancy loss is often caused by chromosomal abnormalities of the conceptus. The prevalence of these abnormalities and the allocation of (ab)normal cells in embryonic and placental lineages during intrauterine development remain elusive. In this study, we analyzed 1,745 spontaneous pregnancy losses and found that roughly half (50.4%) of the products of conception (POCs) were karyotypically abnormal, with maternal and paternal age independently contributing to the increased genomic aberration rate. We applied genome haplarithmisis to a subset of 94 pregnancy losses with normal parental and POC karyotypes. Genotyping of parental DNA as well as POC extra-embryonic mesoderm and chorionic villi DNA, representing embryonic and trophoblastic tissues, enabled characterization of the genomic landscape of both lineages. Of these pregnancy losses, 35.1% had chromosomal aberrations not previously detected by karyotyping, increasing the rate of aberrations of pregnancy losses to 67.8% by extrapolation. In contrast to viable pregnancies where mosaic chromosomal abnormalities are often restricted to chorionic villi, such as confined placental mosaicism, we found a higher degree of mosaic chromosomal imbalances in extra-embryonic mesoderm rather than chorionic villi. Our results stress the importance of scrutinizing the full allelic architecture of genomic abnormalities in pregnancy loss to improve clinical management and basic research of this devastating condition.

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“…2 As one of the most common adverse obstetric complications in pregnancy, RPL not only has a serious impact on the physical and mental health of women, but also can cause the financial burden on the families. [3][4][5] The etiology of RPL is very complicated. Some risk factors, such as advanced age, previous pregnancy loss history, uterine anatomical abnormalities, genetic factors, metabolic and endocrinological factors, thrombophilia, and immunological factors, have been already recognized as associated with RPL.…”

Section: Introductionmentioning

confidence: 99%

“…The risk of pregnancy loss in women of childbearing age is around 15%; in addition, the occurrence of RPL is about 1%–5% 2 . As one of the most common adverse obstetric complications in pregnancy, RPL not only has a serious impact on the physical and mental health of women, but also can cause the financial burden on the families 3–5 . The etiology of RPL is very complicated.…”

Section: Introductionmentioning

confidence: 99%

Predicting risk of subsequent pregnancy loss among women with recurrent pregnancy loss: An immunological factor‐based multivariable model

Mu,

Wang,

Zeng

et al. 2024

American J Rep Immunol

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ProblemStudies on subsequent pregnancy loss prediction models specific for recurrent pregnancy loss (RPL) patients are very limited. This study aims to develop a risk predictive model based on the immunological parameters for the subsequent pregnancy loss risk in northwest Chinese RPL patients.Method of studyTotally of 357 RPL patients recruited from Lanzhou University Second Hospital were included in this retrospective study. Univariate analysis was performed on RPL patients with outcomes of live birth or pregnancy loss. Subsequently, the least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were utilized to select variables among baseline and clinical characteristics and to develop a pregnancy loss risk prediction model with all 357 RPL patients. The area under the curve (AUC), calibration curve and decision curve analyses were used to evaluate the performance of the prediction model; moreover, 10‐fold cross‐validation was used for internal validation.ResultsTen factors of maternal age, age of menarche, previous pregnancy loss, IL‐10, complement 4, IgA, antiprothrombin antibody IgG/IgM, rheumatoid factor IgA, and lupus anticoagulant (LA) 1/LA2 ratio were finally selected as variables for the prediction model of pregnancy loss risk. The AUC value and Hosmer–Lemeshow test p‐value of the model were .707 and .599, respectively, indicating a satisfactory discrimination and calibration performance. Moreover, the clinical decision curve suggested this prediction model have a good positive net benefit.ConclusionsThis is the first prediction model for the risk of subsequent pregnancy loss in northwest Chinese women with RPL, providing a user‐friendly tool to clinicians for the early prediction and timely management of RPL patients.

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Miscarriage syndrome: Linking early pregnancy loss to obstetric and age-related disorders

Cited by 16 publications

References 49 publications

Preconception anti‐annexin A5 antibodies are associated with subsequent live birth in women with recurrent miscarriage: A retrospective study from China

Preconception anti‐annexin A5 antibodies are associated with subsequent live birth in women with recurrent miscarriage: A retrospective study from China

Prevalence of chromosomal alterations in first-trimester spontaneous pregnancy loss

Predicting risk of subsequent pregnancy loss among women with recurrent pregnancy loss: An immunological factor‐based multivariable model

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