Obstet Gynecol Sci.  2016 Sep;59(5):379-387. 10.5468/ogs.2016.59.5.379.

Etiologic characteristics and index pregnancy outcomes of recurrent pregnancy losses in Korean women

• Lee GS
• Park JC
• Rhee JH
• Kim JI

• KMID: 2391688
• DOI: http://doi.org/10.5468/ogs.2016.59.5.379

Abstract

OBJECTIVE
The goal of this study was to evaluate the etiologies and clinical outcomes of Korean recurrent pregnancy loss (RPL) patients. And also, we investigated the differences between primary and secondary RPL patients, between two and three or more pregnancy losses.
METHODS
One hundred seventy eight women diagnosed as RPL were enrolled. We performed chromosomal analysis, thyroid stimulating hormone, prolactin, blood glucose, plasminogen activator inhibitor-1, natural killer cell proportion, anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, anti-β2glycoprotein-1 antibodies, antinuclear antibody, protein C, protein S, antithrombin III, homocysteine, MTFHR gene, factor V Leiden mutation, and hysterosalphingography/hysteroscopic evaluation.
RESULTS
The mean age was 34.03±4.30 years, and mean number of miscarriages was 2.69±1.11 (range, 2 to 11). Anatomical cause (13.5%), chromosomal abnormalities (5.6%), and endocrine disorders (34.3%) were observed in RPL women. Elevated natural killer cell and antiphospholipid antibodies were observed in 43.3% and 7.3% each. Among of 178 women, 77 women were pregnant. After management of those women, live birth rate was 84.4% and mean gestational weeks was 37.63±5.12. Women with three or more RPL compared with women with two RPL had more common anatomical cause such as intrauterine adhesions and lower rates of spontaneous pregnancy. Compare with secondary RPL women, immunological abnormalities were more common in primary RPL. However, miscarriage rates were not different.
CONCLUSION
Immunological factor including autoimmune and alloimmune disorders was most common etiology of RPL. Inherited thrombophilia showed different patterns with other ethnic countries. Miscarriage rates were not different between primary and secondary RPL, or between two and three or more miscarriages group.

Keyword

Clinical outcomes; Etiology; Recurrent pregnancy loss

MeSH Terms

Abortion, Spontaneous
Antibodies, Anticardiolipin
Antibodies, Antinuclear
Antibodies, Antiphospholipid
Antithrombin III
Blood Glucose
Chromosome Aberrations
Factor V
Female
Homocysteine
Humans
Killer Cells, Natural
Live Birth
Lupus Coagulation Inhibitor
Plasminogen Activators
Pregnancy
Pregnancy Outcome*
Pregnancy*
Prolactin
Protein C
Protein S
Thrombophilia
Thyrotropin
Antibodies, Anticardiolipin
Antibodies, Antinuclear
Antibodies, Antiphospholipid
Antithrombin III
Blood Glucose
Factor V
Homocysteine
Lupus Coagulation Inhibitor
Plasminogen Activators
Prolactin
Protein C
Protein S
Thyrotropin

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