Selective chromosome analysis in couples with two or more miscarriages: case-control study.
OBJECTIVE
To identify additional factors, such as maternal age or factors related to previous reproductive outcome or family history, and the corresponding probability of carrying a chromosome abnormality in couples with two or more miscarriages.


METHODS
Nested case-control study.


METHODS
Six centres for clinical genetics in the Netherlands.


METHODS
Couples referred for chromosome analysis after two or more miscarriages in 1992-2000; 279 carrier couples were marked as cases, and 428 non-carrier couples served as controls.


METHODS
Independent factors influencing the probability of carrier status and the corresponding probability of carrier status.


RESULTS
Four factors influencing the probability of carrier status could be identified: maternal age at second miscarriage, a history of three or more miscarriages, a history of two or more miscarriages in a brother or sister of either partner, and a history of two or more miscarriages in the parents of either partner. The calculated probability of carrier status in couples referred for chromosome analysis after two or more miscarriages varied between 0.5% and 10.2%.


CONCLUSIONS
The probability of carrier status in couples with two or more miscarriages is modified by additional factors. Selective chromosome analysis would result in a more appropriate referral policy, could decrease the annual number of chromosome analyses, and could therefore lower the costs.
Franssen
Maureen T M
MT
Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, Netherlands. maureen.franssen@planet.nl
Korevaar
Johanna C
JC
Leschot
Nico J
NJ
Bossuyt
Patrick M M
PM
Knegt
Alida C
AC
Gerssen-Schoorl
Klasien B J
KB
Wouters
Cokkie H
CH
Hansson
Kerstin B M
KB
Hochstenbach
Ron
R
Madan
Kamlesh
K
van der Veen
Fulco
F
Goddijn
Mariette
M
D000022:Abortion, Spontaneous / Q000235:genetics*; D000328:Adult; D016022:Case-Control Studies; D002869:Chromosome Aberrations; D005260:Female; D006580:Genetic Carrier Screening; D006579:Heterozygote; D006801:Humans; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D012044:Regression Analysis