Adverse Pregnancy Outcomes among Women with Prior Spontaneous or Induced Abortions

Michel A. Makhlouf; Rebecca G. Clifton; James M. Roberts; Leslie Myatt; John C. Hauth; Kenneth J. Leveno; Michael W. Varner; John M. Thorp Jr.; Brian M. Mercer; Alan M. Peaceman; Susan M. Ramin; Jay D. Iams; Anthony Sciscione; Jorge E. Tolosa; Yoram Sorokin; for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network

doi:10.1055/s-0033-1358771

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2014; 31(09): 765-772
DOI: 10.1055/s-0033-1358771

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adverse Pregnancy Outcomes among Women with Prior Spontaneous or Induced Abortions

Michel A. Makhlouf

¹Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas

,

Rebecca G. Clifton

²The George Washington University Biostatistics Center, Washington, DC

,

James M. Roberts

³Department of Obstetrics and Gynecology University of Pittsburgh, Pittsburgh, Pennsylvania

,

Leslie Myatt

⁴Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio

,

John C. Hauth

⁵Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama

,

Kenneth J. Leveno

⁶Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

,

Michael W. Varner

⁷Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah

,

John M. Thorp Jr.

⁸Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

,

Brian M. Mercer

⁹Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio

,

Alan M. Peaceman

¹⁰Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois

,

Susan M. Ramin

¹¹Department of Obstetrics and Gynecology University of Texas Health Science Center at Houston, Houston, Texas

,

Jay D. Iams

¹²Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio

,

Anthony Sciscione

¹³Department of Obstetrics and Gynecology, Drexel University, Philadelphia, Pennsylvania

,

Jorge E. Tolosa

¹⁴Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon

,

Yoram Sorokin

¹⁵Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan

,

for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network

› Institutsangaben

Abstract

Objective The aim of the article is to determine whether prior spontaneous abortion (SAB) or induced abortion (IAB), or the interpregnancy interval are associated with subsequent adverse pregnancy outcomes in nulliparous women.

Methods We performed a secondary analysis of data collected from nulliparous women enrolled in a completed trial of vitamins C and E or placebo for preeclampsia prevention. Adjusted odds ratios (ORs) for maternal and fetal outcomes were determined for nulliparous women with prior SABs and IABs as compared with primigravid participants.

Results Compared with primigravidas, women with one prior SAB were at increased risk for perinatal death (adj. OR, 1.5; 95% CI, 1.1–2.3) in subsequent pregnancies. Two or more SABs were associated with an increased risk for spontaneous preterm birth (PTB) (adj. OR, 2.6, 95% CI, 1.7–4.0), preterm premature rupture of membranes (PROM) (adj. OR, 2.9; 95% CI, 1.6–5.3), and perinatal death (adj. OR, 2.8; 95% CI, 1.5–5.3). Women with one previous IAB had higher rates of spontaneous PTB (adj. OR, 1.4; 95% CI, 1.0–1.9) and preterm PROM (OR, 2.0; 95% CI, 1.4–3.0). An interpregnancy interval less than 6 months after SAB was not associated with adverse outcomes.

Conclusion Nulliparous women with a history of SAB or IAB, especially multiple SABs, are at increased risk for adverse pregnancy outcomes.

Keywords

spontaneous abortion - induced abortion - maternal outcomes - neonatal outcomes

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Referenzen

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