CHANCE FOR A LIVE BORN CHILD AFTER MISCARRIAGE
There are two main concerns of couples with recurrent pregnancy loss when they present to our Recurrent Pregnancy Loss Center.
- This first is to explain the reason for their pregnancy losses
- The second is to establish the chance for a successful live born child..
In a first pregnancy, the overall risk of loss of a clinically recognized pregnancy loss is in a young woman is 15 per cent. Studies that evaluated the frequency of pregnancy loss, based on highly sensitive tests for quantitative hCG, indicated that the total clinical and preclinical losses in women aged 20 to 30 is approximately 25%, while the loss rate in women aged 40 or more is at least double that figure.
In the graph above the chance of a live birth was calculated based on the mother’s age and the graph below based on the number of prior pregnancy losses. These data come from a large pregnancy loss clinic in Denmark. Time zero is the time that the patient presented to the pregnancy loss specialist for care. All currently recommended tests and treatments were preformed. Patients were followed up for up to 25 years but most children were born within 5 years. Younger women and women with fewer losses had the best subsequent chance of a live born child.
The ability to predict the risk of recurrence is influenced by several factors including maternal age, lifestyle factors (including obesity, tobacco use, alcohol use), parental and fetal karyotypes, the gestational age at which prior losses occurred, and the presence of various maternal laboratory findings. The number of prior losses also influences the predictions for future success; as the number increases in a couple with unexplained RPL the chance of recurrence increases. Finally, those couples with secondary RPL (at least one live born child and then miscarriages) have a better prognosis in some studies than couples with primary RPL (those couples who have never had a live born child).