Poor obstetric outcome in subsequent pregnancies in women with prior fetal death

Antonio Frias, Rixt A. Luikenaar, Amy E. Sullivan, Richard M. Lee, T. Flint Porter, D. Ware Branch, Robert M. Silver

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

OBJECTIVE: Patients with recurrent first-trimester spontaneous abortion have been the subject of intensive investigation. However, relatively little is known about second- and third-trimester pregnancy loss. Thus, it is difficult for clinicians to optimally counsel, evaluate, and manage women with previous unexplained fetal death. Our objective was to ascertain the outcome of subsequent pregnancies in patients with prior fetal death. METHODS: Subjects were identified from patients referred for evaluation of fetal death (occurring at ≥ 10 weeks of gestation) and having at least one subsequent pregnancy. Patients with antiphospholipid antibodies were excluded. Logistic regression analysis was performed to determine the association of clinical variables with pregnancy outcome. RESULTS: Two hundred thirty subjects met inclusion criteria. Up through the time of their first fetal death, these women had a total of 721 pregnancies, resulting in 268 (37%) live births, 230 (32%) fetal deaths, and 200 (28%) spontaneous abortions. In total, these women had 839 subsequent pregnancies, resulting in 202 (24%) live births, 209 (25%) fetal deaths, and 372 (44%) spontaneous abortions. Univariate logistic regression analysis identified older age at pregnancy (P = .009, odds ratio 0.63, 95% confidence interval 0.42-1.03) and treatment with low-dose aspirin (P = .001, odds ratio 0.41, 95% confidence interval 0.25-0.68) to be associated with a decreased risk for subsequent pregnancy loss. CONCLUSION: Women with prior fetal death are at high risk for subsequent pregnancy loss and recurrent fetal death, with fewer than 25% of pregnancies resulting in surviving infants. These data underscore the need for additional research into the pathophysiology and prevention of recurrent fetal death.

Original languageEnglish (US)
Pages (from-to)521-526
Number of pages6
JournalObstetrics and Gynecology
Volume104
Issue number3
DOIs
StatePublished - Sep 2004
Externally publishedYes

Fingerprint

Fetal Death
Obstetrics
Pregnancy
Spontaneous Abortion
Live Birth
Pregnancy Outcome
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
High-Risk Pregnancy
Antiphospholipid Antibodies
Third Pregnancy Trimester
Second Pregnancy Trimester
First Pregnancy Trimester
Aspirin

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Frias, A., Luikenaar, R. A., Sullivan, A. E., Lee, R. M., Porter, T. F., Branch, D. W., & Silver, R. M. (2004). Poor obstetric outcome in subsequent pregnancies in women with prior fetal death. Obstetrics and Gynecology, 104(3), 521-526. https://doi.org/10.1097/01.AOG.0000137350.89939.2a

Poor obstetric outcome in subsequent pregnancies in women with prior fetal death. / Frias, Antonio; Luikenaar, Rixt A.; Sullivan, Amy E.; Lee, Richard M.; Porter, T. Flint; Branch, D. Ware; Silver, Robert M.

In: Obstetrics and Gynecology, Vol. 104, No. 3, 09.2004, p. 521-526.

Research output: Contribution to journalArticle

Frias, A, Luikenaar, RA, Sullivan, AE, Lee, RM, Porter, TF, Branch, DW & Silver, RM 2004, 'Poor obstetric outcome in subsequent pregnancies in women with prior fetal death', Obstetrics and Gynecology, vol. 104, no. 3, pp. 521-526. https://doi.org/10.1097/01.AOG.0000137350.89939.2a
Frias, Antonio ; Luikenaar, Rixt A. ; Sullivan, Amy E. ; Lee, Richard M. ; Porter, T. Flint ; Branch, D. Ware ; Silver, Robert M. / Poor obstetric outcome in subsequent pregnancies in women with prior fetal death. In: Obstetrics and Gynecology. 2004 ; Vol. 104, No. 3. pp. 521-526.
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