Am J Perinatol 2021; 38(01): 010-015
DOI: 10.1055/s-0040-1713650
SMFM Fellowship Series Article

Perinatal Outcomes in Women with a History of Recurrent Pregnancy Loss

Elizabeth B. Ausbeck
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Christina Blanchard
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Alan T. Tita
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Jeff M. Szychowski
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Lorie Harper
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
› Author Affiliations
Funding None.

Abstract

Objective This study aimed to evaluate perinatal outcomes in women with a history of recurrent pregnancy loss.

Study Design Retrospective cohort study of singleton and nonanomalous gestations at ≥ 20 weeks who delivered at our academic institution. The exposed group was defined as women with a history of ≥ 2 consecutive spontaneous abortions (SABs) at < 12 weeks. These women were compared with women with a history of ≤ 1 SAB at < 12 weeks. The primary outcome was preterm birth (PTB) at < 37 weeks. Secondary outcomes included gestational age at delivery, gestational diabetes, small for gestational age birth weight, hypertensive diseases of pregnancy, fetal demise, cesarean delivery, and a composite of neonatal complications (5-minute Apgar score < 5, perinatal death, and NICU admission). Multivariable logistic regression was performed to adjust for confounders.

Results Of 17,670 women included, 235 (1.3%) had a history of ≥ 2 consecutive SABs. Compared with women with a history of ≤ 1 SAB, women with ≥ 2 consecutive SABs were not more likely to have a PTB (19.6 vs. 14.0%, p = 0.01, adjusted odds ratios (AOR): 0.91, 95% confidence interval [CI]: 0.62–1.33). However, they were more likely to deliver at an earlier mean gestational age (37.8 ± 3.4 vs. 38.6 ± 2.9 weeks, p < 0.01) and to have gestational diabetes (12.3 vs. 6.6%, p < 0.01, AOR: 1.69, 95% CI: 1.10–2.59). Other outcomes were similar between the two groups.

Conclusion A history of ≥ 2 consecutive SABs was not associated with an increased incidence of PTB but may be associated with gestational diabetes in a subsequent pregnancy.

Key Points

  • This was a retrospective cohort study.

  • Women with a history of recurrent pregnancy loss (RPL) were studied.

  • RPL was associated with an increase in preterm birth.

Note

This study was presented as a poster presentation at the Society for Maternal–Fetal Medicine 39th Annual Pregnancy Meeting, Las Vegas, NV, February 14, 2019.




Publication History

Received: 12 March 2020

Accepted: 15 May 2020

Publication Date:
30 June 2020 (online)

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