Effects of enoxaparin on late pregnancy complications and neonatal outcome in women with recurrent pregnancy loss and thrombophilia: results from the Live-Enox study

Recurrent pregnancy loss (RPL), defined as three or more consecutive miscarriages, is hypothesized to share some of the same pathogenic factors as placenta-associated disorders. It has been hypothesized that a defect implantation causes pregnancy loss, while a partially impaired implantation may lead to late pregnancy complications. The aim of this retrospective register-based cohort study was to study the association between RPL and such disorders including pre-eclampsia, stillbirth, small for gestational age (SGA) birth, preterm birth and placental abruption. Women registered with childbirth(s) in the Swedish Medical Birth Register (MFR) were included in the cohort. Pregnancies of women diagnosed with RPL (exposed) in the National Patient Register (NPR), were compared with pregnancies of women without RPL (unexposed/reference). Obstetrical outcomes, in the first pregnancy subsequent to the diagnosis of RPL (n = 4971), were compared with outcomes in reference-pregnancies (n = 57,410). Associations between RPL and placental dysfunctional disorders were estimated by odds ratios (AORs) adjusting for confounders, with logistic regression. RPL women had an increased risk for pre-eclampsia (AOR 1.45; 95% CI; 1.24–1.69), stillbirth <37 gestational weeks (GWs) (AOR 1.92; 95% CI; 1.22–3.02), SGA birth (AOR 1.97; 95% CI; 1.42–2.74), preterm birth (AOR 1.46; 95% CI; 1.20–1.77), and placental abruption <37 GWs (AOR 2.47; 95% CI; 1.62–3.76) compared with pregnancies by women without RPL. Women with RPL had an increased risk of pregnancy complications associated with placental dysfunction. This risk population is, therefore, in need of improved antenatal surveillance.

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Pregnancy-Related Complications in Women with Recurrent Pregnancy Loss: A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm9092833 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2833 ◽

Cited By ~ 1

Author(s):

Carlo Ticconi ◽

Adalgisa Pietropolli ◽

Monia Specchia ◽

Elena Nicastri ◽

Carlo Chiaramonte ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Pregnancy Complications ◽

Prospective Cohort ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Placenta Previa ◽

Intrauterine Fetal Death ◽

Healthy Women ◽

Increased Risk

The aim of this prospective cohort study was to determine whether women with recurrent pregnancy loss (RPL) have an increased risk of pregnancy complications compared to normal pregnant women. A total of 1092 singleton pregnancies were followed, 431 in women with RPL and 661 in normal healthy women. The prevalence of the following complications was observed: threatened miscarriage, miscarriage, cervical insufficiency, chromosomal/genetic abnormalities, fetal anomalies, oligohydramnios, polyhydramnios, fetal growth restriction, intrauterine fetal death, gestational diabetes mellitus (GDM), preeclampsia, placenta previa, abruptio placentae, pregnancy-related liver disorders, and preterm premature rupture of the membranes. The odds ratio and 95% CI for each pregnancy complication considered were determined by comparing women with RPL and normal healthy women. Women with RPL had an overall rate of pregnancy complications higher than normal women (OR = 4.37; 95% CI: 3.353–5.714; p < 0.0001). Their risk was increased for nearly all the conditions considered. They also had an increased risk of multiple concomitant pregnancy complications (OR = 4.64; 95% CI: 3.10–6.94, p < 0.0001). Considering only women with RPL, women with ≥3 losses had a higher risk of pregnancy complications than women with two losses (OR = 1.269; 95% CI: 1.112–2.386, p < 0.02). No differences were found in the overall risk of pregnancy complications according to the type, explained or unexplained, of RPL. Women with secondary RPL had an increased risk of GDM than women with primary RPL. Pregnancy in women with RPL should be considered at high risk.

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Aspirin, low molecular weight heparin, or both in preventing pregnancy complications in women with recurrent pregnancy loss and factor V Leiden mutation

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2019.1671348 ◽

2019 ◽

Vol 33 (11) ◽

pp. 1934-1939 ◽

Cited By ~ 1

Author(s):

Cihan Karadağ ◽

Bertan Akar ◽

Gökçenur Gönenç ◽

Reyhan Aslancan ◽

Nagihan Yılmaz ◽

...

Keyword(s):

Molecular Weight ◽

Pregnancy Complications ◽

Low Molecular Weight Heparin ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Factor V Leiden ◽

Low Molecular Weight ◽

Factor V ◽

Factor V Leiden Mutation

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Hyperhomocysteinemia in Recurrent pregnancy loss

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172907 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2919 ◽

Cited By ~ 1

Author(s):

Nisha Bhatia ◽

Hemanshu B.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Growth Retardation ◽

Pregnancy Complications ◽

Pregnancy Loss ◽

Intrauterine Growth Retardation ◽

Low Birthweight ◽

Recurrent Pregnancy Loss ◽

Hypertensive Disorder ◽

Intrauterine Growth

Background: Hyperhomocysteinemia is associated with many pregnancy related complications. Its association with recurrent pregnancy loss has been investigated recently. Not only it is associated with recurrent pregnancy loss but also associated with complications like Preeclampsia, intrauterine growth retardation and low birth weight. The objective of this study to assess the prevalence of Hyperhomocysteinemia in patients with unexplained recurrent pregnancy loss and to evaluate the association of hyperhomocysteinemia with pregnancy complications in patients of recurrent pregnancy loss.Methods: 50 Patients of unexplained recurrent pregnancy loss were selected as cases and 50 patients with atleast one successful pregnancy were taken as controls. Their blood sample was assayed for Fasting Homocysteine levels. They were followed up throughout pregnancy for any complications and neonatal outcome was recorded.Results: 19 patients out of the 50 cases had Hyperhomocysteinemia. Hyperhomocysteinemia was thrice more common in Primary aborters when compared to secondary aborters. Out of 19 patients with hyperhomocysteinemia in patients with recurrent pregnancy loss, 14 patients also developed Hypertensive disorder of pregnancy during their antenatal period. Among patients with Hyperhomocysteinemia in study group, 47% had low birthweight babies when compared to 25% among control group.Conclusions: Hyperhomocysteinemia is associated with recurrent pregnancy loss and patients of Recurrent pregnancy loss who have Hyperhomocysteinemia have a higher risk of developing pregnancy complications like Preeclampsia, low birth weight and Intrauterine growth retardation.

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Circulating Anti-PLAC1 Antibodies during Pregnancy and in Women with Reproductive Failure: A Preliminary Analysis

ISRN Immunology ◽

10.5402/2011/530491 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Anne C. Kotto-Kome ◽

Celso Silva ◽

Valerie Whiteman ◽

Xiaoyuan Kong ◽

Michael E. Fant

Keyword(s):

Pregnant Women ◽

Sample Size ◽

Pregnancy Complications ◽

Preliminary Analysis ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Unexplained Infertility ◽

Reproductive Failure ◽

Increased Risk ◽

Secondary Outcomes

The aims of this study were to determine the prevalence of anti-PLAC1 antibodies in normal pregnant women and in women with infertility or recurrent pregnancy loss (RPL). Secondary outcomes were the development of complications associated with anti-PLAC1 seropositivity and the rate of seroconversion during pregnancy. Sera from 103 healthy pregnant women and 45 women with unexplained infertility or RPL were analyzed by ELISA. The prevalence of anti-PLAC1 antibodies was 2% in healthy pregnant women and 4.5% in women with unexplained infertility or RPL (P=0.355). There was no detectable association of seropositivity with increased risk of pregnancy complications. Finally, 2% of women seroconverted during pregnancy. The prevalence of anti-PLAC1 antibodies in women with unexplained infertility or RPL is not significantly higher than the prevalence in normal pregnant women. However, the sample size in this study was too small. The exposure to the PLAC1 antigen during pregnancy can lead to the spontaneous development of antibodies.

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