Reproductive outcomes following recurrent first-trimester miscarriage: a retrospective cohort study

Area of Science:

• Reproductive Medicine
• Obstetrics and Gynecology
• Clinical Genetics

Background:

• Recurrent miscarriage (RM) affects 1-3% of reproductive-aged women.
• Known associations include advanced maternal age, obesity, diabetes, and parental translocations.
• Approximately 50% of RM cases remain unexplained after investigations.

Purpose of the Study:

• To determine subsequent reproductive outcomes in women with recurrent miscarriage (RM).
• To analyze livebirth rates, miscarriages, and other adverse pregnancy outcomes.
• To identify factors influencing pregnancy success after RM.

Main Methods:

• Retrospective cohort study of 748 women diagnosed with primary or secondary first-trimester RM.
• Data collected from medical records (2008-2020) at a tertiary university hospital.
• Statistical analysis included chi-squared tests and multinomial regression.

Main Results:

• 77% of women had a subsequent pregnancy; 63% resulted in a livebirth.
• Foetal aneuploidy (15%) was the most common finding; 60% of cases were unexplained.
• Livebirth rates were lower for women aged ≥40 years (44%) and those with infertility (54%).

Conclusions:

• Most women with RM achieve a livebirth, offering reassurance.
• Advanced maternal age, smoking, and parental balanced translocations are associated with reduced pregnancy success.
• Supportive care and risk factor counseling are crucial; a national RM guideline is needed.