M D Stephenson1. 1. Department of Obstetrics and Gynaecology, University of British Columbia, British Columbia's Women's Hospital and Health Centre, Vancouver, Canada.
Abstract
OBJECTIVE: To determine the frequency of factors associated with habitual abortion in 197 couples. DESIGN: Prospective cohort study. SETTING: The British Columbia Recurrent Pregnancy Loss Program, located in a tertiary care academic center. INTERVENTIONS: Diagnostic screening protocol. MAIN OUTCOME MEASURES: Genetic, endocrine, infectious, anatomical, and autoimmune factors associated with habitual abortion. RESULTS: A structural genetic factor was identified in 3.5% of the couples. An endocrine factor, including luteal phase deficiency and hypothyroidism, was identified in 20% and an infectious factor was identified in 0.5% of the couples. An anatomical factor, including various müllerian tract anomalies and severe intrauterine adhesions, was found in 16% and an autoimmune factor, including the antiphospholipid antibody syndrome and the undifferentiated connective tissue syndrome, was identified in 20% of the couples. Eighty-four couples who completed the diagnostic screening protocol were classified as having unexplained habitual abortion. Of these 84 couples, 65% were subclassified as primary, 27% were subclassified as secondary, and 7% had unclassified unexplained habitual abortion. CONCLUSIONS: This large-scale study identified genetic, endocrine, infectious, anatomical, or autoimmune factors in approximately 60% of couples with habitual abortion.
OBJECTIVE: To determine the frequency of factors associated with habitual abortion in 197 couples. DESIGN: Prospective cohort study. SETTING: The British Columbia Recurrent Pregnancy Loss Program, located in a tertiary care academic center. INTERVENTIONS: Diagnostic screening protocol. MAIN OUTCOME MEASURES: Genetic, endocrine, infectious, anatomical, and autoimmune factors associated with habitual abortion. RESULTS: A structural genetic factor was identified in 3.5% of the couples. An endocrine factor, including luteal phase deficiency and hypothyroidism, was identified in 20% and an infectious factor was identified in 0.5% of the couples. An anatomical factor, including various müllerian tract anomalies and severe intrauterine adhesions, was found in 16% and an autoimmune factor, including the antiphospholipid antibody syndrome and the undifferentiated connective tissue syndrome, was identified in 20% of the couples. Eighty-four couples who completed the diagnostic screening protocol were classified as having unexplained habitual abortion. Of these 84 couples, 65% were subclassified as primary, 27% were subclassified as secondary, and 7% had unclassified unexplained habitual abortion. CONCLUSIONS: This large-scale study identified genetic, endocrine, infectious, anatomical, or autoimmune factors in approximately 60% of couples with habitual abortion.
Authors: Michael D Lockshin; Mimi Kim; Carl A Laskin; Marta Guerra; D Ware Branch; Joan Merrill; Michelle Petri; T Flint Porter; Lisa Sammaritano; Mary D Stephenson; Jill Buyon; Jane E Salmon Journal: Arthritis Rheum Date: 2012-07
Authors: Guillermina Girardi; Jessica Berman; Patricia Redecha; Lynn Spruce; Joshua M Thurman; Damian Kraus; Travis J Hollmann; Paolo Casali; Michael C Caroll; Rick A Wetsel; John D Lambris; V Michael Holers; Jane E Salmon Journal: J Clin Invest Date: 2003-12 Impact factor: 14.808