Second-trimester miscarriage and the second pregnancy outcomes--A
Chinese cohort study
Abstract
Objective: This study sought to determine whether second-trimester
miscarriage was associated with an increased risk of recurrent
second-trimester loss and spontaneous preterm birth in the second
pregnancy of Chinese gestational women. Secondary objective was to
examine whether different gestational weeks of second-trimester
miscarriage had different effects on the second pregnancy outcomes.
Study Design: A retrospective cohort study was undertaken in a lager,
tertiary-referral university hospital (6500 deliveries per annum).
Primiparous women with a second-trimester miscarriage (n=75), a
spontaneous preterm birth (n=115), and a full term delivery (n=781)were
identified from January 2015 to December 2017. Medical notes were
reviewed and the number of complications among the three cohorts were
identified. Results:1. Frequencies of subsequent second-trimester loss
were 33.3%, 4.3%, and 1.2% in the second-trimester miscarriage,
spontaneous preterm birth, and full-term delivery cohorts, respectively.
Frequencies of subsequent spontaneous preterm birth were 24%, 38.3%,
and 10.6% in the same 3 cohorts. Patients with a prior second-trimester
miscarriage were 9.9 times more likely to have poor obstetric outcome,
compared with those with prior full-term delivery(confidence interval
6.0 to 16.5, P﹤0.0001). 2.Women with cerclage have lower frequency of
recurrent second-trimester loss and spontaneous PTB(P﹤0.05). 3.The
frequency of poor obstetric outcome in women was 46% vs 65% vs 54% in
those with index loss at less than 18weeks, 18+1-22weeks and longer than
22 weeks.(P =0.5)