PREVALENCE, RISK FACTORS, AND OUTCOMES OF RECURRENT PREGNANCY LOSS: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.48047/kcnkw311Keywords:
Recurrent pregnancy loss, miscarriage, risk factors, antiphospholipid syndrome, South India, cross-sectional studyAbstract
Background: Recurrent pregnancy loss (RPL) is a distressing reproductive condition that affects a substantial proportion of couples seeking obstetric care and carries considerable psychological, clinical, and health-system consequences. In South India, contemporary hospital-based estimates of its burden and associated risk factors remain limited, hampering context-specific counselling and service planning. Objectives: To estimate the prevalence of RPL among women with a history of pregnancy loss attending a tertiary care teaching hospital, to characterise the sociodemographic, obstetric, clinical, and laboratory factors associated with pregnancy loss, and to describe management advice given and short-term follow-up outcomes. Methods: A STROBE-compliant, hospital-based cross-sectional study was conducted at a tertiary care teaching hospital in South India during [study period]. A dataset of 420 women (N = 420) with a history of one or more pregnancy losses, generated for methodological and purposes, was analysed. RPL was defined as two or more clinically recognised pregnancy losses. Sociodemographic, obstetric, associated risk-factor, laboratory, management, and follow-up variables were summarised using descriptive statistics. Results: Mean maternal age was 29.8 ± 7.0 years and mean body mass index (BMI) was 27.3 ± 4.9 kg/m². RPL (≥2 losses) was present in 83 women (19.8%); of these, 25 (6.0%) had primary and 58 (13.8%) secondary RPL. The most frequent associated factors were polycystic ovary syndrome (PCOS) history (15.0%), diabetes or impaired glucose tolerance (11.7%), consanguinity (9.3%), uterine anomaly (8.3%), and thyroid disorder (7.9%). Antiphospholipid antibodies were positive in 4.3% and parental karyotype abnormalities in 2.9%. Most women were advised routine antenatal or preconception care (80.2%). Among 267 currently pregnant women, 194 had ongoing pregnancies and miscarriage during follow-up occurred in 26 (9.7%). Conclusion: In this South Indian tertiary care, approximately one in five women with prior pregnancy loss met criteria for RPL, and metabolic and endocrine factors predominated among associated conditions.
Downloads
References
Dimitriadis E, Menkhorst E, Saito S, Kutteh WH, Brosens JJ. Recurrent pregnancy loss. Nat Rev Dis Primers. 2020;6(1):98. doi:10.1038/s41572-020-00228-z
Magnus MC, Wilcox AJ, Morken NH, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019;364:l869. doi:10.1136/bmj.l869
Patil R, Ghosh K, Vora S, Shetty S. Inherited and acquired thrombophilia in Indian women experiencing unexplained recurrent pregnancy loss. Blood Cells Mol Dis. 2015;55(3):200-205. doi:10.1016/j.bcmd.2015.06.008
Patil R, Ghosh K, Satoskar P, Shetty S. Elevated procoagulant endothelial and tissue factor expressing microparticles in women with recurrent pregnancy loss. PLoS One. 2013;8(11):e81407. doi:10.1371/journal.pone.0081407
Jyotsna PL, Sharma S, Trivedi SS. Coagulation inhibitors and activated protein C resistance in recurrent pregnancy losses in Indian women. Indian J Pathol Microbiol. 2011;54(4):752-755. doi:10.4103/0377-4929.91507
Kutteh WH, Hinote CD. Antiphospholipid antibody syndrome. Obstet Gynecol Clin North Am. 2014;41(1):113-132. doi:10.1016/j.ogc.2013.10.004
Duckitt K, Qureshi A. Recurrent miscarriage. BMJ Clin Evid. 2011;2011:1409. PMID:21718553
Schreiber K, Hunt BJ. Pregnancy and Antiphospholipid Syndrome. Semin Thromb Hemost. 2016;42(7):780-788. doi:10.1055/s-0036-1592336
Grandone E, Villani M, Tiscia GL. Aspirin and heparin in pregnancy. Expert Opin Pharmacother. 2015;16(12):1793-1803. doi:10.1517/14656566.2015.1066335
Hickey SE, Curry CJ, Toriello HV. ACMG Practice Guideline: lack of evidence for MTHFR polymorphism testing. Genet Med. 2013;15(2):153-156. doi:10.1038/gim.2012.165
Legendre G, Gicquel M, Lejeune V, et al. [Psychology and pregnancy loss]. J Gynecol Obstet Biol Reprod (Paris). 2014;43(10):908-917. doi:10.1016/j.jgyn.2014.09.019
Page JM, Silver RM. Genetic Causes of Recurrent Pregnancy Loss. Clin Obstet Gynecol. 2016;59(3):498-508. doi:10.1097/GRF.0000000000000217
Hyde KJ, Schust DJ. Genetic considerations in recurrent pregnancy loss. Cold Spring Harb Perspect Med. 2015;5(3):a023119. doi:10.1101/cshperspect.a023119
Suzumori N, Sugiura-Ogasawara M. Genetic factors as a cause of miscarriage. Curr Med Chem. 2010;17(29):3431-3437. doi:10.2174/092986710793176302
Brezina PR, Kutteh WH. Classic and cutting-edge strategies for the management of early pregnancy loss. Obstet Gynecol Clin North Am. 2013;41(1):1-18. doi:10.1016/j.ogc.2013.10.011
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
