Second-trimester miscarriage a risk factor for future pregnancies

Second-trimester miscarriage should be highlighted as a risk factor for adverse outcomes in subsequent pregnancies, a new study has warned.

The study conducted by researchers in Cork found that “women experiencing second-trimester miscarriage are at increased risk in subsequent pregnancies of recurrence”.

Published in the European Journal of Obstetrics and Gynaecology, the study recommends further research into its pathophysiology in order to advance preventative measures.

The research aimed to determine the rates of recurrence, pre-term birth and live births in a cohort of 185 women who experienced second-trimester miscarriage.

Conducted at Cork University Maternity Hospital (CUMH), the study followed-up 175 women who had confirmed second-trimester miscarriage between June 2009 and June 2013 and subsequently had a pregnancy between July 2009 and January 2016. Some 55 women did not become pregnant during the study.

The results revealed that between July 2009 and January 2016, some 110 women became pregnant following a previous second-trimester miscarriage.

Including those who experienced first- or second-trimester miscarriage, 47 per cent (78/155) of those who were followed up did not go on to have a live infant.

In total, 81 babies were born to 77 mothers. The recurrence rate of second-trimester miscarriage was 6.3 per cent and the pre-term birth rate was also 6.3 per cent. The Caesarean section rate was high at 45 per cent.

“The reassuring message is that most women have a successful pregnancy following a second-trimester miscarriage,” according to the researchers. “The rate of recurrence and pre-term birth is lower than previously quoted. There is a notable risk compared to the general population however, meriting close observation during pregnancy, particularly women with a history of periviable loss.”

The article ‘Subsequent pregnancy outcomes following second-trimester miscarriage – a prospective cohort study’ was undertaken by researchers at CUMH; the National Perinatal Epidemiology Centre, University College Cork; and the INFANT centre, Cork.