Recurrent miscarriage I: definition and epidemiology

doi:10.1016/0140-6736(90)92159-F

The Lancet

Volume 336, Issue 8716, 15 September 1990, Pages 673-675

https://doi.org/10.1016/0140-6736(90)92159-F Get rights and content

Abstract

On epidemiological evidence, the definition of recurrent miscarriage should be three or more consecutive pregnancy losses. Data should be collected to 28 weeks' gestation but analysis up to 20-22 weeks' or 500 g fetal weight should also be possible. General practitioners and gynaecologists should do what they feel is suitable for couples whose history does not meet these criteria but a diagnosis of recurrent miscarriage should not be made. Women meeting the definition can be subdivided into primary and secondary groups, respectively consisting of those who have lost all previous pregnancies and those who have had one successful pregnancy followed by consecutive losses.

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This review article summarises the evidence for intergenerational trends observed to date within infertility and pregnancy loss. There appears to be evidence of intergenerational trends between mothers and daughters for the age at menopause, endometriosis, polycystic ovarian syndrome (PCOS), male factor infertility and miscarriage. At present, there is no evidence for a predisposition to stillbirth between mothers and daughters. One study found an association with familial predisposition for ectopic pregnancy. Very few studies have considered the potential for paternal transmission of risk of infertility or pregnancy loss. The majority of studies to date have significant limitations because of their observational design, risk of recall bias and risk of confounding. Therefore, high-quality well-designed research, with multi-centre collaboration and utilisation of registry-based data sources and individual patient data, is needed to understand whether infertility and pregnancy loss may have heritable factors. Epidemiological findings need to be followed up and investigated with translational research to determine the possible causalities as well as any implications for clinical practice.
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REVIEW ARTICLERecurrent miscarriage I: definition and epidemiology

Abstract

Lancet

Fertil Steril

Lancet

Am J Obstet Gynecol

WHO recommended definitions, terminology and format for statistical tables related to the perinatal period

Act Obstet Gynecol Scand

Spontaneous abortion risks in man: data from reproductive histories collected in a medical genetics unit

Hum Genet

Incidence of early loss in pregnancy

N Engl J Med

Incidence of early loss in pregnancy

N Engl J Med

REVIEW ARTICLE
Recurrent miscarriage I: definition and epidemiology