title: Number and sequence of preceding miscarriages and maternal age for the prediction of antiphospholipid syndrome in women with recurrent miscarriage.
abstract: OBJECTIVE
  To investigate the relationship between the number and sequence of preceding miscarriages and antiphospholipid syndrome (APS).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Recurrent miscarriage (RM) clinic.
  
  
  METHODS
  Women who attended the RM clinic from 1988 to 2006.
  
  
  METHODS
  None.
  
  
  METHODS
  Number, type, and sequence of previous pregnancies were compared between women with APS and women with unexplained RM.
  
  
  RESULTS
  A total of 1,719 patients were included; 312 (18%) had APS, and 1,407 (82%) had unexplained RM. The mean maternal age (32.6 years) did not differ between women with and without APS. The median number of miscarriages was three in both groups. A total of 865 women (50%) had a history of at least one live birth, with no difference between the two groups. In both groups, 97% of the women had a history of consecutive miscarriages.
  
  
  CONCLUSIONS
  The number of preceding miscarriage, type and sequence of previous pregnancies, and maternal age were not associated with APS in women with RM. There is no increased diagnostic yield for APS after three miscarriages rather than after two miscarriages and no increased diagnostic yield for APS after consecutive miscarriages rather than after nonconsecutive miscarriages. Therefore, APS testing should be considered for all women with two or more miscarriages.
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Emmy
authors.initials: E
authors.lastname: van den Boogaard
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Danny M
authors.initials: DM
authors.lastname: Cohn
authors.affiliation: Department of Clinical Epidemiology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Korevaar
authors.affiliation: Department of Obstetrics and Gynaecology, Liverpool Women's Hospital, Liverpool, United Kingdom.
authors.forename: Feroza
authors.initials: F
authors.lastname: Dawood
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Rosa
authors.initials: R
authors.lastname: Vissenberg
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Middeldorp
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Mariette
authors.initials: M
authors.lastname: Goddijn
authors.affiliation: Department of Obstetrics and Gynaecology, Liverpool Women's Hospital, Liverpool, United Kingdom. Electronic address: roy.farquharson@lwh.nhs.uk.
authors.forename: Roy G
authors.initials: RG
authors.lastname: Farquharson
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology*; D000328:Adult; D000367:Age Factors; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors