Advertisement

Archives of Gynecology and Obstetrics

, Volume 271, Issue 4, pp 350–354 | Cite as

Is there a higher prevalence of pregnancy complications in a live-birth preceding the appearance of recurrent abortions?

  • Adi Y. Weintraub
  • Eyal SheinerEmail author
  • Asher Bashiri
  • Ilana Shoham-Vardi
  • Moshe Mazor
Original Article

Abstract

Objective

The present study was designed to evaluate the prevalence of pregnancy complications in a live-birth preceding the appearance of recurrent abortions.

Methods

A case-control study comparing women who had at least two consecutive spontaneous abortions after one live birth with matched controls, without recurrent abortions, was performed. Cases were recruited from the Recurrent Abortions Clinic. The women in the control group were matched by the following parameters: age, pregnancy order and having had a live birth in the same year as the study group. Four controls were matched for each case. The analysis focused on the characteristics of the live-birth preceding the recurrent abortions of the study group and the births of the matched controls.

Results

From Jan 2001 through Dec 2002, 140 women were examined in the Outpatient Clinic for Recurrent Abortions. Of these, 58 women who had a live-birth prior to at least two consecutive spontaneous abortions comprised the study group, which was compared with 232 controls. A statistically significant higher rate of preeclampsia (mild and severe) was found in a live-birth preceding recurrent abortions than in the matched controls (10.3 vs. 3.9%, p=0.047). In addition, a nonsignificant trend was found for higher rates of non-reassuring fetal heart rate patterns (8.6 vs. 3.0%, p=0.055) in this group. No other significant differences regarding maternal or neonatal complications such as placental abruption, intrauterine growth restriction, and intrauterine fetal death were noted between the groups.

Conclusions

A live-birth preceding the appearance of recurrent abortions is associated with a higher rate of preeclampsia.

Keywords

Recurrent abortions Pregnancy complications Preeclampsia Thrombophilia 

Notes

Acknowledgements

We thank Hillel Vardi and Noel Nelson for their help with the analysis of the data and Denis Weintraub for his help with the editing of this paper.

References

  1. 1.
    Adelberg AM, Kuller JA (2002) Thrombophilias and recurrent miscarriage. Obstet Gynecol Surv 57:703–709CrossRefPubMedGoogle Scholar
  2. 2.
    Alonso A, Soto I, Urgelles MF, Corte JR, Rodriguez MJ, Pinto CR (2002) Acquired and inherited thrombophilia in women with unexplained fetal losses. Am J Obstet Gynecol 187:1337–1342CrossRefPubMedGoogle Scholar
  3. 3.
    American College of Obstetricians and Gynecologists (2001) Management of recurrent early pregnancy loss. Number 24, February 2001. ACOG Pract Bull 24:1–8Google Scholar
  4. 4.
    American College of Obstetricians and Gynecologists (2001) Gestational diabetes. ACOG Practice Bulletin Number 30, September 2001. ACOG Committee on Practice Bulletins. Obstet Gynecol 98:525–538PubMedGoogle Scholar
  5. 5.
    American College of Obstetricians and Gynecologists (2002) Diagnosis and management of preeclampsia and eclampsia. ACOG Practice Bulletin Number 33, January 2002. ACOG Committee on Obstetric Practice. Int J Gynaecol Obstet 77:67–75CrossRefPubMedGoogle Scholar
  6. 6.
    Bick RL (2000) Recurrent miscarriage syndrome and infertility caused by blood coagulation protein or platelet defects. Hematol Oncol Clin North Am 14:1117–1131PubMedGoogle Scholar
  7. 7.
    Blumenfeld Z, Brenner B (1999) Thrombophilia-associated pregnancy wastage. Fertil Steril 72:765–774CrossRefPubMedGoogle Scholar
  8. 8.
    De Groot CJM, Bloemenkamp KWM, Duvekot EJ, Helmerhorst FM, Bertina RM, Van Der Meer F, De Ronde H, Guid Oei S, Kanhai HHH, Rosendaal FR (1999) Preeclampsia and genetic risk factors for thrombosis: a case-control study. Am J Obstet Gynecol 181:975–980PubMedGoogle Scholar
  9. 9.
    De Vries JIP, Dekker GA, Huijgens PC, Jakobs C, Blomberg BME, van Geijn HP (1997) Hyperhomocysteinemia and protein S deficiency in complicated pregnancies. Br J Obstet Gynaecol 104:1248–1254PubMedGoogle Scholar
  10. 10.
    Dizon-Townson DS, Nelson LM, Easton K, Ward K (1996) The factor V Leiden mutation may predispose women to severe preeclampsia. Am J Obstet Gynecol 175:902–905PubMedGoogle Scholar
  11. 11.
    Eldor A (2001) Thrombophilia, thrombosis and pregnancy. Thromb Haemost 86:104–111PubMedGoogle Scholar
  12. 12.
    Foka ZF, Lambropoulos H, Karas GB, Karavida A, Agorastos T, Zournatzi V, Makris PE, Bontis J, Kotsis A (2000) Factor V Leiden and prothrombin G20210A mutations, but not methylenetetrahydrofolate reductase C677T, are associated with recurrent miscarriages. Hum Reprod 15:458–462CrossRefPubMedGoogle Scholar
  13. 13.
    Infante-Rivard C, Rivard GE, Yotov WV, Genin E, Guiguet M, Weinberg C, Gauthier R, Feoli-Fonseca JC (2002) Absence of association of thrombophilia polymorphisms with intrauterine growth restriction. N Engl J Med 347:19–25CrossRefPubMedGoogle Scholar
  14. 14.
    Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB (1999) Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med 340:9–13CrossRefPubMedGoogle Scholar
  15. 15.
    Kupferminc MJ, Fait G, Many A, Gordon D, Eldor A, Lessing JB (2000) Severe preeclampsia and high frequency of genetic thrombophilic mutations. Obstet Gynecol 96:45–49CrossRefPubMedGoogle Scholar
  16. 16.
    Livingston JC, Barton JR, Park V, Haddad B, Phillips O, Sibai BM (2001) Maternal and fetal inherited thrombophilias are not related to the development of severe preeclampsia. Am J Obstet Gynecol 185:153–157CrossRefPubMedGoogle Scholar
  17. 17.
    Many A, Schreiber L, Rosner S, Lessing JB, Eldor A, Kupferminc MJ (2001) Pathologic features of the placenta in women with severe pregnancy complications and thrombophilia. Obstet Gynecol 98:1041–1044CrossRefPubMedGoogle Scholar
  18. 18.
    Ogunyemi D, Ku W, Arkel Y (2002) The association between inherited thrombophilia, antiphospholipid antibodies and lipoprotein A levels with obstetric complications in pregnancy. J Thromb Thrombolysis 14:157–162CrossRefPubMedGoogle Scholar
  19. 19.
    Peeters LLH (2001) Thrombophilia and fetal growth restriction. Eur J Obstet Gynecol Reprod Biol 95:202–205CrossRefPubMedGoogle Scholar
  20. 20.
    Preston FE, Rosendaal FR, Walker ID, Briet E, Berntorp E, Conrad J, Fontcuberta J, Makris M, Mariani G, Noteboom W, Pabinger I, Legnani C, Scharrer I, Schulman S, Van Der Meer FJM (1996) Increased fetal loss in women with heritable thrombophilia. Lancet 348:913–916CrossRefPubMedGoogle Scholar
  21. 21.
    Rai R, Shlebak A, Cohen H, Backos M, Holmes Z, Marriott K, Regan L (2001) Factor V Leiden and acquired activated protein C resistance among 1000 women with recurrent miscarriage. Hum Reprod 16:961–965CrossRefPubMedGoogle Scholar
  22. 22.
    Raziel A, Kornberg Y, Friedler S, Schachter M, Sela BA, Ron-El R (2001) Hypercoagulable thrombophilic defects and hyperhomocysteinemia in patients with recurrent pregnancy loss. Am J Reprod Immunol 46:65–71CrossRefGoogle Scholar
  23. 23.
    Regan L, Rai R (2002) Thrombophilia and pregnancy loss. J Reprod Immunol 55:163–180CrossRefPubMedGoogle Scholar
  24. 24.
    Rey E, Kahn SR, David M, Shrier I (2003) Thrombophilic disorders and fetal loss: a meta-analysis. Lancet 361:901–908CrossRefPubMedGoogle Scholar
  25. 25.
    Sarig G, Younis JS, Hoffman R, Lanir N, Blumenfeld Z, Brenner B (2002) Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage. Fertil Steril 77:342–347CrossRefPubMedGoogle Scholar
  26. 26.
    Sheiner E, Shoham-Vardi I, Hadar A, Hallak M, Hackmon R, Mazor M (2002) Incidence, obstetric risk factors and pregnancy outcome of preterm placental abruption: a retrospective analysis. J Matern Fetal Neonatal Med 11:34–39PubMedGoogle Scholar
  27. 27.
    Sheiner E, Shoham-Vardi I, Hallak M, Hadar A, Gorchak L, Katz M, Mazor M (2003) Placental abruption in term pregnancies: clinical significance and obstetric risk factors. J Matern Fetal Neonatal Med 13:45–49PubMedGoogle Scholar
  28. 28.
    Wiener-Megnagi Z, Ben-Shlomo I, Goldberg Y, Shalev E (1998) Resistance to activated protein C and the Leiden mutation: high prevalence in patients with abruptio placentae. Am J Obstet Gynecol 179:1565–1567PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Adi Y. Weintraub
    • 1
  • Eyal Sheiner
    • 1
    Email author
  • Asher Bashiri
    • 1
  • Ilana Shoham-Vardi
    • 2
  • Moshe Mazor
    • 1
  1. 1.Department of Obstetrics and Gynecology Faculty of Health Sciences, Soroka University Medical CenterBen Gurion University of the NegevBeer-ShevaIsrael
  2. 2.Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Soroka University Medical CenterBen Gurion University of the NegevBeer-ShevaIsrael

Personalised recommendations