Michel A Makhlouf1, Rebecca G Clifton2, James M Roberts3, Leslie Myatt4, John C Hauth5, Kenneth J Leveno6, Michael W Varner7, John M Thorp8, Brian M Mercer9, Alan M Peaceman10, Susan M Ramin11, Jay D Iams12, Anthony Sciscione13, Jorge E Tolosa14, Yoram Sorokin15. 1. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas. 2. The George Washington University Biostatistics Center, Washington, DC. 3. Department of Obstetrics and Gynecology University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio. 5. Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama. 6. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas. 7. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah. 8. Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 9. Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio. 10. Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois. 11. Department of Obstetrics and Gynecology University of Texas Health Science Center at Houston, Houston, Texas. 12. Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio. 13. Department of Obstetrics and Gynecology, Drexel University, Philadelphia, Pennsylvania. 14. Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon. 15. Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan.
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 ofvitamins C and E or placebofor 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
RCT Entities:
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: A J Wilcox; C R Weinberg; J F O'Connor; D D Baird; J P Schlatterer; R E Canfield; E G Armstrong; B C Nisula Journal: N Engl J Med Date: 1988-07-28 Impact factor: 91.245
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Authors: Yujing J Heng; Craig E Pennell; Sheila W McDonald; Angela E Vinturache; Jingxiong Xu; Mary W F Lee; Laurent Briollais; Andrew W Lyon; Donna M Slater; Alan D Bocking; Lawrence de Koning; David M Olson; Siobhan M Dolan; Suzanne C Tough; Stephen J Lye Journal: PLoS One Date: 2016-06-22 Impact factor: 3.240