Predictors of Pregnancy Success in Repeated Miscarriage

Abstract

Factors that may have a bearing on subsequent pregnancy success or failure in patients with recurrent abortion were examined in 165 women with a history of three or more consecutive miscarriages in the first trimester. The overall success rate was 67.9%. Factors that were found to correlate significantly with success rate were length of abortion history, total number of abortions, interval from last miscarriage to present pregnancy, and whether there was any degree of subfertility. Logistic regression analysis showed that the abortion x years index and maternal age accounted for all the variation observed in our data. Where all other known causes of abortions are excluded, recurrent aborters can be subdivided into two populations--namely, those with a relatively good prognosis characterized by a short abortion history and absence of subfertility problems, compared to those with a poor prognosis namely those with a long abortion history or presence of subfertility problems. These data clearly demonstrate major differences in success rates in women depending on the number of abortions and the length of abortion history (abortion x year index), particularly in women over the age of 30 years.

Genetic findings in miscarriages and their relation to the number of previous miscarriages

“…Compelling data suggest that the recurrence risk of chromosomal aberration mainly depends on maternal age because increasing age is associated with a higher aneuploidy rate, especially trisomy risk. Even the absence of other risk factors, being older than 30 years is a risk factor for sporadic and repeated pregnancy loss [18][19][20]. In accordance with the well-known age-dependent decreasing oocyte quality associated with increasing aneuploidy rates, particularly above the age of 35 years [21], we found a higher total number of chromosomal embryonic abnormalities in the older group (at least 35 years old) compared to their younger counterparts.…”

“…The overall prevalence of chromosomal abnormalities in aborted material was 64.3% in our study. Comparably high genetic aberrations rates after miscarriages have been reported in previous publications [14,[16][17][18][19].…”

Two-year outcome after recurrent first trimester miscarriages: prognostic value of the past obstetric history

“…Moreover, factors derived from the obstetric history, e.g., maternal age and number of preceding miscarriages, independently have a negative impact on the prognosis [ 8 , 11 , 12 ]. Miscarriages have also been linked to subfertility [ 13 ].…”

Pregnancy Loss in the Antiphospholipid Syndrome

“…First trimester miscarriages have many causes, and second trimester fetal deaths have been considered to be more characteristic of antiphospholipid antibody syndrome. [15][16][17][18][19] There is general agreement that women meeting both criteria (positive for antiphospholipid antibody and having two or more prior fetal losses, regardless of duration of pregnancy) should be treated.…”