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Wu CQ, Nichols K, Carwana M, Cormier N, Maratta C. Preterm birth after recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril 2022; 117:811-819. [DOI: 10.1016/j.fertnstert.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/19/2022]
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Hematological Profile of Pregnant Women with Suspected Zika Virus Infection Followed Up at a Referral Service in Manaus, Brazil. Viruses 2021; 13:v13040710. [PMID: 33923877 PMCID: PMC8072789 DOI: 10.3390/v13040710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of this paper is to describe the hematological profile of pregnant women with suspected Zika virus (ZIKV) infection followed up at a reference service for infectious diseases in Manaus, Brazil, through a clinical, epidemiological, cross-sectional study of pregnant women with an exanthematic manifestation who looked for care between 2015 and 2017. The participants were 499 pregnant women, classified into four subgroups, according to laboratory confirmation of infections: ZIKV-positive; ZIKV-positive and positive for another infection; positive for another infection but not ZIKV-positive; and not positive for any of the infections investigated. Hematological parameters were analyzed descriptively. The association between maternal infection and the hematological profile, along with the association between the maternal hematological profile and the gestational outcome, were tested. Similar hematic and platelet parameters were observed among pregnant women. However, a significant association was observed between low maternal lymphocyte count and a positive diagnosis for ZIKV (p < 0.001). The increase in maternal platelet count and the occurrence of unfavorable gestational outcome were positively associated. A similar hematic and platelet profile was identified among pregnant women, differing only in the low lymphocyte count among ZIKV-positive pregnant women. Regarding gestational outcomes, in addition to the damage caused by ZIKV infection, altered maternal platelets may lead to unfavorable outcomes, with the need for adequate follow-up during prenatal care.
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Ji W, Hou B, Li W, Guo F, He P, Zheng J. Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study. BMC Pregnancy Childbirth 2021; 21:46. [PMID: 33430833 PMCID: PMC7802326 DOI: 10.1186/s12884-020-03528-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/26/2020] [Indexed: 11/22/2022] Open
Abstract
Background In recent years, first-trimester intrauterine hematoma (IUH) has become increasingly common in twin pregnancy. The majority of studies on IUH have excluded twin pregnancies, and others did not differentiate between singleton and twin pregnancies. The impact of IUH on twin pregnancy is unclear. Therefore, the primary objective of our study was to examine associations between first-trimester IUH and pregnancy outcomes in twin pregnancies. Methods The data of 1020 twin pregnancies in women who received a routine examination from January 2014 to December 2018 were reviewed. We compared baseline data and pregnancy outcomes between those with and without IUH. Multivariable logistic regression analysis was used to adjust for possible confounding factors. Results A total of 209 patients (21.3%) developed IUH in the first trimester. First-trimester IUH was significantly associated with increased odds of miscarriage (adjusted odds ratio 14.27, 95% CI 8.25–24.70) and vanishing twin syndrome (adjusted odds ratio 3.26, 95% CI 1.11–4.61). However, there were no differences in the rates of stillbirth, preeclampsia, preterm labor (< 34 weeks), low birth weight, postpartum hemorrhage or fetal distress between the two groups. Maternal age, previous preterm birth, chorionicity in twins and the gestational week at first ultrasound did not differ between the two groups. The women with IUH had high rates of previous miscarriage (46.73% vs 38.37%, p = 0.01), assisted conception (48.56% vs 32.60%, p < 0.001) and accompanied vaginal bleeding (67.46% vs 13.43%, p < 0.001). According to the logistic regression analyses, these characteristics were not associated with pregnancy loss or vanishing twin syndrome. No IUH characteristics, including volume, largest diameter, or the presence of vaginal bleeding, were associated with pregnancy loss or vanishing twin syndrome before 20 weeks of gestation (P > 0.05). Conclusion In women with twin pregnancy, the presence of IUH in the first trimester was associated with the loss of one or both fetuses before 20 weeks of gestation. However, previous miscarriage, the conception method, the IUH size and the presence of vaginal bleeding were not independently associated with miscarriage or vanishing twin syndrome.
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Affiliation(s)
- Wanqing Ji
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong Province, China
| | - Bo Hou
- Departments of Neurosurgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, Guangdong Province, China
| | - Weidong Li
- Department of Woman and Child Health Information Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Fang Guo
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong Province, China
| | - Ping He
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong Province, China.
| | - Jie Zheng
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong Province, China.
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Rasmark Roepke E, Christiansen OB, Källén K, Hansson SR. Women with a History of Recurrent Pregnancy Loss Are a High-Risk Population for Adverse Obstetrical Outcome: A Retrospective Cohort Study. J Clin Med 2021; 10:E179. [PMID: 33419111 PMCID: PMC7825424 DOI: 10.3390/jcm10020179] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 11/16/2022] Open
Abstract
Recurrent pregnancy loss (RPL), defined as three or more consecutive miscarriages, is hypothesized to share some of the same pathogenic factors as placenta-associated disorders. It has been hypothesized that a defect implantation causes pregnancy loss, while a partially impaired implantation may lead to late pregnancy complications. The aim of this retrospective register-based cohort study was to study the association between RPL and such disorders including pre-eclampsia, stillbirth, small for gestational age (SGA) birth, preterm birth and placental abruption. Women registered with childbirth(s) in the Swedish Medical Birth Register (MFR) were included in the cohort. Pregnancies of women diagnosed with RPL (exposed) in the National Patient Register (NPR), were compared with pregnancies of women without RPL (unexposed/reference). Obstetrical outcomes, in the first pregnancy subsequent to the diagnosis of RPL (n = 4971), were compared with outcomes in reference-pregnancies (n = 57,410). Associations between RPL and placental dysfunctional disorders were estimated by odds ratios (AORs) adjusting for confounders, with logistic regression. RPL women had an increased risk for pre-eclampsia (AOR 1.45; 95% CI; 1.24-1.69), stillbirth <37 gestational weeks (GWs) (AOR 1.92; 95% CI; 1.22-3.02), SGA birth (AOR 1.97; 95% CI; 1.42-2.74), preterm birth (AOR 1.46; 95% CI; 1.20-1.77), and placental abruption <37 GWs (AOR 2.47; 95% CI; 1.62-3.76) compared with pregnancies by women without RPL. Women with RPL had an increased risk of pregnancy complications associated with placental dysfunction. This risk population is, therefore, in need of improved antenatal surveillance.
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Affiliation(s)
- Emma Rasmark Roepke
- Institute of Clinical Sciences Lund, Lund University, 22100 Lund, Sweden; (K.K.); (S.R.H.)
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Jan Waldenströmsgatan 47, 20502 Malmö, Sweden
| | - Ole Bjarne Christiansen
- Centre for Recurrent Pregnancy Loss of Western Denmark, Department of Obstetrics and Gynaecology, Aalborg University Hospital, Clinical Institute at Aalborg University, 9220 Aalborg, Denmark;
| | - Karin Källén
- Institute of Clinical Sciences Lund, Lund University, 22100 Lund, Sweden; (K.K.); (S.R.H.)
| | - Stefan R. Hansson
- Institute of Clinical Sciences Lund, Lund University, 22100 Lund, Sweden; (K.K.); (S.R.H.)
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Jan Waldenströmsgatan 47, 20502 Malmö, Sweden
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Galletta MAK, Bittar RE, Agra I, Guerra ECL, Francisco RPV, Zugaib M. Epidemiological profile of patients with preterm premature rupture of membranes at a tertiary hospital in São Paulo, Brazil. Clinics (Sao Paulo) 2019; 74:e1231. [PMID: 31644662 PMCID: PMC6791291 DOI: 10.6061/clinics/2019/e1231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/30/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To perform a descriptive analysis of preterm premature rupture of membranes (PPROM) cases attended in a tertiary hospital. METHOD Retrospective analysis of medical records and laboratory tests of patients admitted to a Brazilian tertiary hospital between 2006 and 2011, with a confirmed diagnosis of PPROM and gestational age (GA) at delivery <37 weeks. RESULTS A total of 299 pregnant women were included in the study. Nine patients evolved to abortion, and 290 pregnant women remained for the final analysis. There was initial diagnostic doubt in 17.6% of the cases. The oligohydramnios rate [amniotic fluid index (AFI) <5] was 27.9% on admission. Chorioamnionitis was initially diagnosed in 10.8% of the patients and was retrospectively confirmed in 22.9% of the samples. The latency period had a mean of 9.1 days. The main reasons for interruption were premature labor (55.2%), GA ≥36 weeks (27.2%), and fetal distress (6.9%). The delivery method was cesarean section in 55% of cases. The mean birth weight was 2,124 grams, and 67% of the neonates had a low birth weight (<2500 g). The GA at delivery averaged 33.5 weeks. The stillbirth rate was 5.3%, and the early neonatal mortality rate was 5.6%. There were complications at delivery in 18% of mothers. CONCLUSION In one of the few Brazilian reports on the epidemiological profile of PPROM, with GA until 37 weeks and intercurrences generally excluded from assessments (such as twinning and fetal malformations), there is a favorable evolution, with an acceptable rate of complications.
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Shapiro GD, Séguin JR, Muckle G, Monnier P, Fraser WD. Previous pregnancy outcomes and subsequent pregnancy anxiety in a Quebec prospective cohort. J Psychosom Obstet Gynaecol 2017; 38:121-132. [PMID: 28079434 PMCID: PMC5383417 DOI: 10.1080/0167482x.2016.1271979] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Pregnancy anxiety is an important psychosocial risk factor that may be more strongly associated with adverse birth outcomes than other measures of stress. Better understanding of the upstream predictors and causes of pregnancy anxiety could help to identify high-risk women for adverse maternal and infant outcomes. The objective of the present study was to measure the associations between five past pregnancy outcomes (live preterm birth (PTB), live term birth, miscarriage at <20 weeks, stillbirth at ≥20 weeks, and elective abortion) and pregnancy anxiety at three trimesters in a subsequent pregnancy. METHODS Analyses were conducted using data from the 3D Cohort Study, a Canadian birth cohort. Data on maternal demographic characteristics and pregnancy history for each known previous pregnancy were collected via interviewer-administered questionnaires at study entry. Pregnancy anxiety for the index study pregnancy was measured prospectively by self-administered questionnaire following three prenatal study visits. RESULTS Of 2366 participants in the 3D Study, 1505 had at least one previous pregnancy. In linear regression analyses with adjustment for confounding variables, prior live term birth was associated with lower pregnancy anxiety in all three trimesters, whereas prior miscarriage was significantly associated with higher pregnancy anxiety in the first trimester. Prior stillbirth was associated with greater pregnancy anxiety in the third trimester. Prior elective abortion was significantly associated with higher pregnancy anxiety scores in the first and second trimesters, with an association of similar magnitude observed in the third trimester. DISCUSSION Our findings suggest that the outcomes of previous pregnancies should be incorporated, along with demographic and psychosocial characteristics, into conceptual models framing pregnancy anxiety.
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Affiliation(s)
- Gabriel D. Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada,CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada
| | - Jean R. Séguin
- CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada,Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Gina Muckle
- Centre de Recherche du Centre hospitalier universitaire de Québec, Quebec, Canada,École de psychologie, Université Laval, Quebec, Canada
| | - Patricia Monnier
- Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Canada
| | - William D. Fraser
- CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada,Department of Obstetrics and Gynaecology, Université de Sherbrooke, and Centre de recherche du CHUS, Sherbrooke, Canada
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Pregnancy loss history at first parity and selected adverse pregnancy outcomes. Ann Epidemiol 2016; 26:474-481.e9. [PMID: 27262817 DOI: 10.1016/j.annepidem.2016.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/22/2016] [Accepted: 04/26/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate the association between pregnancy loss history and adverse pregnancy outcomes. METHODS Pregnancy history was captured during a computer-assisted personal interview for 21,277 women surveyed in the National Survey of Family Growth (1995-2013). History of pregnancy loss (<20 weeks) at first parity was categorized in three ways: number of losses, maximum gestational age of loss(es), and recency of last pregnancy loss. We estimated risk ratios for a composite measure of selected adverse pregnancy outcomes (preterm, stillbirth, or low birthweight) at first parity and in any future pregnancy, separately, using predicted margins from adjusted logistic regression models. RESULTS At first parity, compared with having no loss, having 3+ previous pregnancy losses (adjusted risk ratio (aRR) = 1.66 [95% CI = 1.13, 2.43]), a maximum gestational age of loss(es) at ≥10 weeks (aRR = 1.28 [1.04, 1.56]) or having experienced a loss 24+ months ago (aRR = 1.36 [1.10, 1.68]) were associated with increased risks of adverse pregnancy outcomes. For future pregnancies, only having a history of 3+ previous pregnancy losses at first parity was associated with increased risks (aRR = 1.97 [1.08, 3.60]). CONCLUSION Number, gestational age, and recency of pregnancy loss at first parity were associated with adverse pregnancy outcomes in U.S. women.
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Hiersch L, Ashwal E, Aviram A, Rayman S, Wiznitzer A, Yogev Y. The association between previous single first trimester abortion and pregnancy outcome in nulliparous women. J Matern Fetal Neonatal Med 2015; 29:1457-61. [DOI: 10.3109/14767058.2015.1051022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Makhlouf MA, Clifton RG, Roberts JM, Myatt L, Hauth JC, Leveno KJ, Varner MW, Thorp JM, Mercer BM, Peaceman AM, Ramin SM, Iams JD, Sciscione A, Tolosa JE, Sorokin Y. Adverse pregnancy outcomes among women with prior spontaneous or induced abortions. Am J Perinatol 2014; 31:765-72. [PMID: 24347257 PMCID: PMC4061262 DOI: 10.1055/s-0033-1358771] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of the article is to determine whether prior spontaneous abortion (SAB) or induced abortion (IAB), or the interpregnancy interval are associated with subsequent adverse pregnancy outcomes in nulliparous women. METHODS We performed a secondary analysis of data collected from nulliparous women enrolled in a completed trial of vitamins C and E or placebo for preeclampsia prevention. Adjusted odds ratios (ORs) for maternal and fetal outcomes were determined for nulliparous women with prior SABs and IABs as compared with primigravid participants. RESULTS Compared with primigravidas, women with one prior SAB were at increased risk for perinatal death (adj. OR, 1.5; 95% CI, 1.1-2.3) in subsequent pregnancies. Two or more SABs were associated with an increased risk for spontaneous preterm birth (PTB) (adj. OR, 2.6, 95% CI, 1.7-4.0), preterm premature rupture of membranes (PROM) (adj. OR, 2.9; 95% CI, 1.6-5.3), and perinatal death (adj. OR, 2.8; 95% CI, 1.5-5.3). Women with one previous IAB had higher rates of spontaneous PTB (adj. OR, 1.4; 95% CI, 1.0-1.9) and preterm PROM (OR, 2.0; 95% CI, 1.4-3.0). An interpregnancy interval less than 6 months after SAB was not associated with adverse outcomes. CONCLUSION Nulliparous women with a history of SAB or IAB, especially multiple SABs, are at increased risk for adverse pregnancy outcomes.
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Affiliation(s)
- Michel A Makhlouf
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Rebecca G Clifton
- The George Washington University Biostatistics Center, Washington, DC
| | - James M Roberts
- Department of Obstetrics and Gynecology University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Leslie Myatt
- Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio
| | - John C Hauth
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kenneth J Leveno
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michael W Varner
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
| | - John M Thorp
- Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brian M Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio
| | - Alan M Peaceman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
| | - Susan M Ramin
- Department of Obstetrics and Gynecology University of Texas Health Science Center at Houston, Houston, Texas
| | - Jay D Iams
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
| | - Anthony Sciscione
- Department of Obstetrics and Gynecology, Drexel University, Philadelphia, Pennsylvania
| | - Jorge E Tolosa
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon
| | - Yoram Sorokin
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
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Risk of placental dysfunction disorders after prior miscarriages: a population-based study. Am J Obstet Gynecol 2014; 211:34.e1-8. [PMID: 24495667 DOI: 10.1016/j.ajog.2014.01.041] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/13/2013] [Accepted: 01/28/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of the investigation was to study the association between prior miscarriages and the risks of placental dysfunction disorders, including preeclampsia, stillbirth, birth of a small for gestational age (SGA) infant, placental abruption, and spontaneous preterm birth. STUDY DESIGN In a population-based cohort study including 619,587 primiparous women, we estimated risks of placental dysfunction disorders for women with 1 (n = 68,185), 2 (n = 11,410) and 3 or more (n = 3823) self-reported prior miscarriages. Risks were calculated as odds ratios by unconditional logistic regression analysis and adjustments were made for maternal age, early pregnancy body mass index, height, smoking habits, country of birth, years of formal education, in vitro fertilization, chronic hypertension, pregestational diabetes, hypothyroidism, systemic lupus erythematosis, fetal sex, and year of childbirth. RESULTS Compared with women with no prior miscarriage, women with 1 prior miscarriage had almost no increased risks. Women with 2 prior miscarriages had increased risks of spontaneous preterm birth, preterm (<37 weeks) SGA infant, and placental abruption. The rates of all disorders were higher for women with 3 or more prior miscarriages compared with women without prior miscarriages: preeclampsia, 5.83% vs 4.27%; stillbirth, 0.69% vs 0.33%, SGA infant, 5.09% vs 3.22%, placental abruption, 0.81% vs 0.41%; and spontaneous preterm birth, 6.45% vs 4.40%. The adjusted odds ratios for preterm (<37 weeks) disorders in women with 3 prior miscarriages were approximately 2. CONCLUSION History of 2 or more miscarriages is associated with an increased risk of placental dysfunction disorders and should be regarded as a risk factor in antenatal care.
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Greenberg T, Tzivian L, Harlev A, Serjienko R, Mazor M, Bashiri A. Index pregnancy versus post-index pregnancy in patients with recurrent pregnancy loss. J Matern Fetal Neonatal Med 2014; 28:63-7. [DOI: 10.3109/14767058.2014.900752] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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McCarthy FP, Khashan AS, North RA, Rahma MB, Walker JJ, Baker PN, Dekker G, Poston L, McCowan LME, O'Donoghue K, Kenny LC. Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth. Hum Reprod 2013; 28:3197-206. [DOI: 10.1093/humrep/det332] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Weintraub AY, Sergienko R, Harlev A, Holcberg G, Mazor M, Wiznitzer A, Sheiner E. An initial miscarriage is associated with adverse pregnancy outcomes in the following pregnancy. Am J Obstet Gynecol 2011; 205:286.e1-5. [PMID: 22071067 DOI: 10.1016/j.ajog.2011.06.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 05/07/2011] [Accepted: 06/13/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of the study was to determine whether 1 previous miscarriage is associated with an increased rate of adverse pregnancy outcomes in the following pregnancy. STUDY DESIGN Second pregnancies of women with and without a miscarriage in their initial pregnancy were compared. Multivariable logistic regression models were constructed to control for confounders. RESULTS Of 35,125 singleton deliveries in the second pregnancy, 5777 (16.4%) were of patients with an initial miscarriage. Multivariable analysis showed a significant association between a previous miscarriage and the following adverse pregnancy outcomes including premature rupture of membranes (odds ratio [OR], 2.22; 95% confidence interval [CI], 2.01-2.44), preterm delivery (OR, 1.34; 95% CI, 1.21-1.48), intrauterine growth restriction (OR, 1.24; 95% CI, 1.04-1.47), hypertensive disorders (OR 1.41; 95% CI 1.07-1.85), preeclampsia (OR, 1.63; 95% CI, 1.22-2.18), and cesarean delivery (OR, 1.59; 95% CI, 1.46-1.73). Perinatal mortality was significantly higher among women with an initial miscarriage (1.6% vs 1.0%; P < .001). CONCLUSION An initial miscarriage is independently associated with adverse pregnancy outcomes.
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Bhattacharya S, Townend J, Bhattacharya S. Recurrent miscarriage: Are three miscarriages one too many? Analysis of a Scottish population-based database of 151,021 pregnancies. Eur J Obstet Gynecol Reprod Biol 2010; 150:24-7. [DOI: 10.1016/j.ejogrb.2010.02.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 01/18/2010] [Accepted: 02/03/2010] [Indexed: 11/16/2022]
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van Oppenraaij R, Jauniaux E, Christiansen O, Horcajadas J, Farquharson R, Exalto N. Predicting adverse obstetric outcome after early pregnancy events and complications: a review. Hum Reprod Update 2009; 15:409-21. [DOI: 10.1093/humupd/dmp009] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Bhattacharya S, Bhattacharya S. Effect of Miscarriage on Future Pregnancies. WOMENS HEALTH 2009; 5:5-8. [DOI: 10.2217/17455057.5.1.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Sohinee Bhattacharya
- Sohinee Bhattacharya, Division of Applied Medicine, School of Medicine, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, AB25 2ZD, Scotland, Tel.: +44 122 455 4672, Fax: +44 122 455 3708,
| | - Siladitya Bhattacharya
- Siladitya Bhattacharya, Division of Applied Medicine, School of Medicine, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, AB25 2ZD, Scotland, Tel.: +44 122 455 0590, Fax: +44 122 455 9948,
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Bhattacharya S, Townend J, Shetty A, Campbell D, Bhattacharya S. Does miscarriage in an initial pregnancy lead to adverse obstetric and perinatal outcomes in the next continuing pregnancy? BJOG 2008; 115:1623-9. [DOI: 10.1111/j.1471-0528.2008.01943.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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