Pregnancy outcome following a previous spontaneous abortion (miscarriage).
OBJECTIVE
To determine the pregnancy outcome following a previous spontaneous abortion (miscarriage).


METHODS
A prospective cohort study was done on 300 gravida-2 patients: 200 patients (case group) whose previous pregnancy was spontaneously aborted (early abortion), and 100 patients (control group) whose previous pregnancy went to term and a live fetus was delivered. All the patients were followed until delivery, and then the pregnancy outcomes, neonatal complications and delivery routes were determined and compared between the 2 groups. Pregnancy outcomes included: maternal complications (e.g. placenta previa, placental abruption, premature rupture of the membranes, preeclampsia and eclampsia, abortion, breech presentation, preterm labor, intrauterine fetal death); neonatal complications (low birth weight, gross congenital malformations, low Apgar score at 1 min), and delivery routes (cesarean delivery or instrumental delivery, e.g. forceps or vacuum). Statistical analysis was performed using the Statistical Package for Social Science.


RESULTS
Statistical analysis showed that the pregnancy complications following a previous spontaneous miscarriage were no different from those of the control group, except for abortion (16.5 vs. 11%, p < 0.003, RR = 1.15, CI 95% = 0.95-1.39), fetal deaths (1.5 vs. 0%, p < 0.004, RR = 1.51, CI 95% = 1.39-1.63), and vaginal bleeding during the first trimester (19 vs. 1%, p < 0.001, RR = 1.57, CI 95% = 1.41-1.75), which were more than those of the control group. Also, the rate of cesarean delivery (28.14 vs. 13.48%) was increased (p = 0.026, RR = 1.25, CI 95% = 1.07-1.47). Neonatal complications were not statistically significantly different in comparison with the control group.


CONCLUSIONS
A prior spontaneous miscarriage is a risk for the next pregnancy, and the risk of abortion and intrauterine fetal death will increase. Therefore, careful prenatal care is mandatory.
Kashanian
M
M
Department of Obstetrics and Gynecology, Akbar Abadi Teaching Hospital, Iran University of Medical Sciences, 16117 Tehran, Iran. marayamkashanian@yahoo.com
Akbarian
A R
AR
Baradaran
H
H
Shabandoust
S H
SH
D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D018570:Risk Assessment; D014219:Trial of Labor