History of miscarriage and increased incidence of fetal aneuploidy in subsequent pregnancy

Katherine Bianco, Aaron Caughey, Brian Shaffer, Regina Davis, Mary E. Norton

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this study was to examine the association between history of spontaneous abortion and aneuploidy in a subsequent pregnancy. METHODS: This was a retrospective cohort study of women who underwent fetal karyotype analysis with amniocentesis or chorionic villus sampling at a single prenatal diagnosis center. Information on spontaneous abortions, parity, maternal age, ethnicity, type of prenatal diagnosis, and karyotype was assessed. Univariable and multivariable analyses were conducted. RESULTS: A total of 46,939 women were included in our analysis. Women with no prior spontaneous abortions had a 1.39% risk for any aneuploidy. In women with one prior spontaneous abortion, this risk increased to 1.67%; for women with 2 previous spontaneous abortions, the risk increased to 1.84%; and for those women who had had 3 or more prior spontaneous abortions, the risk increased further to 2.18% (P <.007). When controlling for maternal age, parity, ethnicity, and mode of prenatal diagnosis and compared with women with no prior spontaneous abortions, women with one prior spontaneous abortion (adjusted odds ratio [AOR] 1.21, 95% confidence interval [CI] 1.01-1.47) or 3 or more prior spontaneous abortions (AOR 1.51, 95% CI 1.02-2.25) had a statistically significant increase in aneuploidy in a subsequent pregnancy. Women with 2 prior spontaneous abortions had an AOR of 1.26 for aneuploidy, but the 95% CI contained unity. CONCLUSION: An increased risk of karyotypic abnormality identified at the time of prenatal diagnosis is demonstrated in patients with an increasing number of spontaneous abortions. This study provides information regarding this risk among women presenting for prenatal diagnosis. According to our data, for a woman with an a priori risk of 1 in 300 for Down syndrome, 3 prior spontaneous abortions would increase that risk by 47% to 1 in 204. These results should be confirmed in low-risk populations.

Original languageEnglish (US)
Pages (from-to)1098-1102
Number of pages5
JournalObstetrics and Gynecology
Volume107
Issue number5
DOIs
StatePublished - May 2006
Externally publishedYes

Fingerprint

Aneuploidy
Spontaneous Abortion
Pregnancy
Incidence
Prenatal Diagnosis
Odds Ratio
Maternal Age
Confidence Intervals
Parity
Karyotype
Chorionic Villi Sampling
Amniocentesis
Induced Abortion
Down Syndrome
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

History of miscarriage and increased incidence of fetal aneuploidy in subsequent pregnancy. / Bianco, Katherine; Caughey, Aaron; Shaffer, Brian; Davis, Regina; Norton, Mary E.

In: Obstetrics and Gynecology, Vol. 107, No. 5, 05.2006, p. 1098-1102.

Research output: Contribution to journalArticle

Bianco, Katherine ; Caughey, Aaron ; Shaffer, Brian ; Davis, Regina ; Norton, Mary E. / History of miscarriage and increased incidence of fetal aneuploidy in subsequent pregnancy. In: Obstetrics and Gynecology. 2006 ; Vol. 107, No. 5. pp. 1098-1102.
@article{8ef9300895124f45ba7e34e4a3cc74dd,
title = "History of miscarriage and increased incidence of fetal aneuploidy in subsequent pregnancy",
abstract = "OBJECTIVE: The purpose of this study was to examine the association between history of spontaneous abortion and aneuploidy in a subsequent pregnancy. METHODS: This was a retrospective cohort study of women who underwent fetal karyotype analysis with amniocentesis or chorionic villus sampling at a single prenatal diagnosis center. Information on spontaneous abortions, parity, maternal age, ethnicity, type of prenatal diagnosis, and karyotype was assessed. Univariable and multivariable analyses were conducted. RESULTS: A total of 46,939 women were included in our analysis. Women with no prior spontaneous abortions had a 1.39{\%} risk for any aneuploidy. In women with one prior spontaneous abortion, this risk increased to 1.67{\%}; for women with 2 previous spontaneous abortions, the risk increased to 1.84{\%}; and for those women who had had 3 or more prior spontaneous abortions, the risk increased further to 2.18{\%} (P <.007). When controlling for maternal age, parity, ethnicity, and mode of prenatal diagnosis and compared with women with no prior spontaneous abortions, women with one prior spontaneous abortion (adjusted odds ratio [AOR] 1.21, 95{\%} confidence interval [CI] 1.01-1.47) or 3 or more prior spontaneous abortions (AOR 1.51, 95{\%} CI 1.02-2.25) had a statistically significant increase in aneuploidy in a subsequent pregnancy. Women with 2 prior spontaneous abortions had an AOR of 1.26 for aneuploidy, but the 95{\%} CI contained unity. CONCLUSION: An increased risk of karyotypic abnormality identified at the time of prenatal diagnosis is demonstrated in patients with an increasing number of spontaneous abortions. This study provides information regarding this risk among women presenting for prenatal diagnosis. According to our data, for a woman with an a priori risk of 1 in 300 for Down syndrome, 3 prior spontaneous abortions would increase that risk by 47{\%} to 1 in 204. These results should be confirmed in low-risk populations.",
author = "Katherine Bianco and Aaron Caughey and Brian Shaffer and Regina Davis and Norton, {Mary E.}",
year = "2006",
month = "5",
doi = "10.1097/01.AOG.0000215560.86673.22",
language = "English (US)",
volume = "107",
pages = "1098--1102",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - History of miscarriage and increased incidence of fetal aneuploidy in subsequent pregnancy

AU - Bianco, Katherine

AU - Caughey, Aaron

AU - Shaffer, Brian

AU - Davis, Regina

AU - Norton, Mary E.

PY - 2006/5

Y1 - 2006/5

N2 - OBJECTIVE: The purpose of this study was to examine the association between history of spontaneous abortion and aneuploidy in a subsequent pregnancy. METHODS: This was a retrospective cohort study of women who underwent fetal karyotype analysis with amniocentesis or chorionic villus sampling at a single prenatal diagnosis center. Information on spontaneous abortions, parity, maternal age, ethnicity, type of prenatal diagnosis, and karyotype was assessed. Univariable and multivariable analyses were conducted. RESULTS: A total of 46,939 women were included in our analysis. Women with no prior spontaneous abortions had a 1.39% risk for any aneuploidy. In women with one prior spontaneous abortion, this risk increased to 1.67%; for women with 2 previous spontaneous abortions, the risk increased to 1.84%; and for those women who had had 3 or more prior spontaneous abortions, the risk increased further to 2.18% (P <.007). When controlling for maternal age, parity, ethnicity, and mode of prenatal diagnosis and compared with women with no prior spontaneous abortions, women with one prior spontaneous abortion (adjusted odds ratio [AOR] 1.21, 95% confidence interval [CI] 1.01-1.47) or 3 or more prior spontaneous abortions (AOR 1.51, 95% CI 1.02-2.25) had a statistically significant increase in aneuploidy in a subsequent pregnancy. Women with 2 prior spontaneous abortions had an AOR of 1.26 for aneuploidy, but the 95% CI contained unity. CONCLUSION: An increased risk of karyotypic abnormality identified at the time of prenatal diagnosis is demonstrated in patients with an increasing number of spontaneous abortions. This study provides information regarding this risk among women presenting for prenatal diagnosis. According to our data, for a woman with an a priori risk of 1 in 300 for Down syndrome, 3 prior spontaneous abortions would increase that risk by 47% to 1 in 204. These results should be confirmed in low-risk populations.

AB - OBJECTIVE: The purpose of this study was to examine the association between history of spontaneous abortion and aneuploidy in a subsequent pregnancy. METHODS: This was a retrospective cohort study of women who underwent fetal karyotype analysis with amniocentesis or chorionic villus sampling at a single prenatal diagnosis center. Information on spontaneous abortions, parity, maternal age, ethnicity, type of prenatal diagnosis, and karyotype was assessed. Univariable and multivariable analyses were conducted. RESULTS: A total of 46,939 women were included in our analysis. Women with no prior spontaneous abortions had a 1.39% risk for any aneuploidy. In women with one prior spontaneous abortion, this risk increased to 1.67%; for women with 2 previous spontaneous abortions, the risk increased to 1.84%; and for those women who had had 3 or more prior spontaneous abortions, the risk increased further to 2.18% (P <.007). When controlling for maternal age, parity, ethnicity, and mode of prenatal diagnosis and compared with women with no prior spontaneous abortions, women with one prior spontaneous abortion (adjusted odds ratio [AOR] 1.21, 95% confidence interval [CI] 1.01-1.47) or 3 or more prior spontaneous abortions (AOR 1.51, 95% CI 1.02-2.25) had a statistically significant increase in aneuploidy in a subsequent pregnancy. Women with 2 prior spontaneous abortions had an AOR of 1.26 for aneuploidy, but the 95% CI contained unity. CONCLUSION: An increased risk of karyotypic abnormality identified at the time of prenatal diagnosis is demonstrated in patients with an increasing number of spontaneous abortions. This study provides information regarding this risk among women presenting for prenatal diagnosis. According to our data, for a woman with an a priori risk of 1 in 300 for Down syndrome, 3 prior spontaneous abortions would increase that risk by 47% to 1 in 204. These results should be confirmed in low-risk populations.

UR - http://www.scopus.com/inward/record.url?scp=33646769627&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646769627&partnerID=8YFLogxK

U2 - 10.1097/01.AOG.0000215560.86673.22

DO - 10.1097/01.AOG.0000215560.86673.22

M3 - Article

VL - 107

SP - 1098

EP - 1102

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 5

ER -