Risk Factors and Outcomes of Recurrent Pregnancy Loss in Japan.

Abstract

AIM:

To clarify the risk factors and pregnancy outcomes for each risk factor of recurrent pregnancy loss (RPL) in Japan.

METHODS:

Using a prospective RPL database collected from 16 facilities in Japan, the prevalence of risk factors for RPL, their treatments and pregnancy outcomes were examined.

RESULTS:

Of 6663 patients registered in our database, 5708 patients had RPL. All examinations for risk factors were performed for 1340 patients (23.5%). The prevalences of positive antiphospholipid antibodies (aPL), malformation of the uterus, thyroid dysfunction, parental karyotype abnormality, factor XII deficiency, protein S deficiency and unknown risk factors were 8.7%, 7.9%, 9.5%, 3.7%, 7.6%, 4.3% and 65.1%, respectively. Although factor XII deficiency and protein S deficiency are not recognized as risk factors for RPL in general, low-dose aspirin (LDA) or unfractionated heparin + LDA therapy improved live birth rates. In transiently aPL-positive patients, the live birth rate with LDA therapy was similar to that with heparin + LDA. For unknown risk factors of RPL, the live birth rate in normal fetal karyotype in the none treatment group was similar to that in all other treatments group (81.3% vs 86.0%). Of 5708 RPL patients, pregnancy outcomes were known for 2261 patients and 1697 patients (75.1%) had at least one live birth.

CONCLUSION:

The risk factors and pregnancy outcomes for each risk factor of RPL are useful for clinicians and patients. Factor XII deficiency and protein S deficiency may be risk factors of RPL.

• Authors: Keiko Morita, Yosuke Ono, Toshiyuki Takeshita, Toshitaka Sugi, Tomoyuki Fujii, Hideto Yamada, Mikiya Nakatsuka, Atsushi Fukui, Shigeru Saito
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 45 Issue 10 Pg. 1997-2006 (Oct 2019) ISSN: 1447-0756 [Electronic] Australia
• PMID: 31397532 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2019 Japan Society of Obstetrics and Gynecology.

Topics

• Abortion, Habitual (epidemiology, prevention & control)
• Adult
• Birth Rate
• Female
• Humans
• Japan (epidemiology)
• Pregnancy
• Pregnancy Outcome (epidemiology)
• Prospective Studies
• Risk Factors