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  • Artigos Originais

    Epidemiological and obstetrics aspects in women with recurrent pregnancy losses at a public maternity in the Brazilian Northeast

    Rev Bras Ginecol Obstet. 2014;36(11):514-518

    Summary

    Artigos Originais

    Epidemiological and obstetrics aspects in women with recurrent pregnancy losses at a public maternity in the Brazilian Northeast

    Rev Bras Ginecol Obstet. 2014;36(11):514-518

    DOI 10.1590/S0100-720320140005007

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    PURPOSE:

    To describe the epidemiologic and obstetric characteristics of women with recurrent miscarriages.

    METHODS:

    A descriptive and analytical study whose inclusion criterion was every woman that was attended at the clinic for recurrent miscarriage (loss group), between January 2006 and December 2010. Patients that did not live in Salvador, Bahia, Brazil, and those who were not reached by telephone or whose number was not included in the medical record were not included. The Control Group consisted of 204 pregnant women seen at the low-risk prenatal care unit between May 2007 and April 2008. Women who did not accept to be interviewed and those with obstetric risk were excluded from the Control Group. The analyzed variables were: age, education, occupation, marital status, alcohol consumption, body mass index, obstetric history and the gestational age when the losses occurred. The SPSS 18.0 program was used for statistical analysis. Means and standard deviations of continuous variables were compared using the Student's t-test and the frequencies of the nominal variables were compared by the χ2 test.

    RESULTS:

    The mean age of women in the loss group was higher than in the Control Group (32.3±6.3 versus 26.5±6.4 years old, p<0.01). Consumption of alcoholic beverages predominated in the loss group (36.9 versus 22.1%, p=0.01), as well as marital status (93.2 versus 66.7% were married or living in a stable union, p<0.01). The pre-pregnancy body mass index was higher in the loss group (26.9 versus 23.5%, p<0.01). Regarding obstetric history, 103 women with recurrent miscarriage reported 334 pregnancies. Fifty-six of them had 2 or more miscarriages in the first quarter and in 31 of them, 2 or more pregnancies progressed to late abortions/extremely preterm infants.

    CONCLUSIONS:

    Some risk factors were identified in women with recurrent losses, such as more advanced age and higher body mass index. These observations agree with more recent proposals regarding recurrent losses that consider the inclusion of losses in various gestational ages.

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  • Original Article

    Reproductive outcome in pregnant women with recurrent pregnancy loss

    Rev Bras Ginecol Obstet. 2015;37(12):578-584

    Summary

    Original Article

    Reproductive outcome in pregnant women with recurrent pregnancy loss

    Rev Bras Ginecol Obstet. 2015;37(12):578-584

    DOI 10.1590/SO100-720320150005445

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    Abstract

    PURPOSE:

    To estimate the future pregnancy success rate in women with a history of recurrent pregnancy loss.

    METHODS:

    A retrospective cohort study including 103 women seen at a clinic for recurrent pregnancy loss (loss group) between January 2006 and December 2010 and a control group including 204 pregnant women seen at a low-risk prenatal care unit between May 2007 and April 2008. Both groups were seen in the university teaching hospital the Maternidade Climério de Oliveira, Salvador, Bahia, Brazil. Reproductive success rate was defined as an alive-birth, independent of gestational age at birth and survival after the neonatal period. Continuous variables Means and standard deviations (SD) were compared using Student's t-test and nominal variables proportions by Pearson χ2test.

    RESULTS:

    Out of 90 who conceived, 83 (91.2%) had reproductive success rate. There were more full-term pregnancies in the control than in the loss group (174/187; 92.1 versus 51/90; 56.7%; p<0.01). The prenatal visits number was satisfactory for 76 (85.4%) women in the loss group and 125 (61.3%) in the control (p<0.01). In this, the beginning of prenatal care was earlier (13.3; 4.2 versus 19.6; 6.9 weeks). During pregnancy, the loss group women increased the weight more than those in the control group (58.1 versus 46.6%; p=0.04). Although cervix cerclage was performed in 32/90 women in the loss group, the pregnancy duration mean was smaller (34.8 weeks; SD=5.6 versus 39.3 weeks; SD=1.6; p<0.01) than in the control group. Due to gestational complications, cesarean delivery predominated in the loss group (55/83; 64.7 versus 73/183; 39.5%; p<0.01).

    CONCLUSION:

    A very good reproductive success rate can be attributed to greater availability of healthcare services to receive pregnant women, through prenatal visits (scheduled or not), cervical cerclage performed on time, and available hospital care for the mother and newborn.

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