Consecutive or non-consecutive recurrent miscarriage: is there any difference in carrier status?
BACKGROUND
Carrier status of a structural balanced chromosome abnormality is associated with recurrent miscarriage. There is, at present, no evidence of the impact of the sequence of preceding pregnancies on the probability of carrier status. The aim of our study was therefore to examine whether the history of consecutive versus non-consecutive miscarriages in couples with two or more miscarriages has any impact on the probability of carrying a chromosome abnormality.


METHODS
A nested case-control study was performed in six centres for clinical genetics in the Netherlands. Couples referred for chromosome analysis after two or more miscarriages were included: 279 couples with a carrier of a structural chromosomal abnormality and 428 non-carrier couples who served as controls. Univariable and multivariable logistic regression analyses, corrected for known risk factors for carrier status, were performed. The main outcome measure was the probability of carrier status.


RESULTS
Two hundred and fifty-six of 279 (92%) carrier couples and 381 of 428 (89%) non-carrier couples had experienced consecutive miscarriages (P = 0.21). A history of two or three consecutive miscarriages did not alter the probability of carrier status when compared with two [odds ratio (OR) 0.90, 95% confidence interval (CI) 0.48-1.7] or three (OR 0.71, 95% CI 0.39-1.3) non-consecutive miscarriages.


CONCLUSIONS
The sequence of preceding pregnancies is not a risk factor for carrier status. Therefore, couples with miscarriages interspersed with healthy child(ren) should be managed the same as couples with consecutive miscarriages regarding chromosome diagnosis.
van den Boogaard
E
E
Department of Obstetrics and Gynaecology, Academic Medical Center, Centre for Reproductive Medicine, H4-205, PO Box 22660, 1100 DD Amsterdam, The Netherlands. e.vandenboogaard@amc.uva.nl
Kaandorp
S P
SP
Franssen
M T M
MT
Mol
B W J
BW
Leschot
N J
NJ
Wouters
C H
CH
van der Veen
F
F
Korevaar
J C
JC
Goddijn
M
M
D000026:Abortion, Habitual / Q000235:genetics*; D000328:Adult; D016022:Case-Control Studies; D002869:Chromosome Aberrations; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D007621:Karyotyping; D016015:Logistic Models; D008297:Male; D009426:Netherlands; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires