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Women with a history of recurrent pregnancy loss are a high-risk population for adverse obstetrical outcome : A retrospective cohort study

Roepke, Emma Rasmark LU ; Christiansen, Ole Bjarne ; Källén, Karin LU and Hansson, Stefan R. LU orcid (2021) In Journal of Clinical Medicine 10(2). p.1-12
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... (More)

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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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Intrauterine growth restriction, Placental abruption, Pre-eclampsia, Preterm birth, Recurrent pregnancy loss, Stillbirth
in
Journal of Clinical Medicine
volume
10
issue
2
article number
179
pages
12 pages
publisher
MDPI AG
external identifiers
  • scopus:85114069950
  • pmid:33419111
ISSN
2077-0383
DOI
10.3390/jcm10020179
language
English
LU publication?
yes
id
d5b8293f-7263-40a7-86e3-11d43622481a
date added to LUP
2021-10-05 14:31:38
date last changed
2024-04-20 13:23:50
@article{d5b8293f-7263-40a7-86e3-11d43622481a,
  abstract     = {{<p>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 &lt;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 &lt;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.</p>}},
  author       = {{Roepke, Emma Rasmark and Christiansen, Ole Bjarne and Källén, Karin and Hansson, Stefan R.}},
  issn         = {{2077-0383}},
  keywords     = {{Intrauterine growth restriction; Placental abruption; Pre-eclampsia; Preterm birth; Recurrent pregnancy loss; Stillbirth}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{1--12}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of Clinical Medicine}},
  title        = {{Women with a history of recurrent pregnancy loss are a high-risk population for adverse obstetrical outcome : A retrospective cohort study}},
  url          = {{http://dx.doi.org/10.3390/jcm10020179}},
  doi          = {{10.3390/jcm10020179}},
  volume       = {{10}},
  year         = {{2021}},
}