Second-trimester loss and subsequent pregnancy outcomes: What is the real risk?
OBJECTIVE
This study was performed to determine whether second-trimester pregnancy loss was associated with an increased risk for spontaneous preterm birth or recurrent second-trimester loss in a subsequent pregnancy.


METHODS
A retrospective cohort study was conducted. Patients with a second-trimester pregnancy loss (n = 38), a spontaneous preterm birth (n = 76), and a full term delivery (n = 76) were identified from 2002 to 2005 (index pregnancy). Computerized medical records were used to obtain demographic and obstetrical histories.


RESULTS
Frequencies of subsequent second-trimester loss were 27%, 3%, and 1% in the second-trimester loss, spontaneous preterm birth, and full-term delivery cohorts, respectively. Frequencies of subsequent spontaneous preterm birth were 33%, 39.5%, and 9% in the same 3 cohorts. Patients with a prior second-trimester loss were 10.8 times more likely to have recurrent second-trimester loss or spontaneous preterm birth, compared with those with prior full-term delivery (confidence interval 3.6 to 32.1, P < .0001).


CONCLUSIONS
Patients with a prior second-trimester loss are at significantly increased risk for spontaneous preterm birth and recurrent second-trimester loss in their next pregnancy.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Andrea G
AG
Edlow
Sindhu K
SK
Srinivas
Michal A
MA
Elovitz
D000026:Abortion, Habitual / Q000453:epidemiology; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology*; D012307:Risk Factors