title: Risk factors associated with a new pregnancy loss and perinatal outcomes in cases of recurrent miscarriage treated with lymphocyte immunotherapy.
abstract: OBJECTIVE
  To assess the perinatal outcomes and risk factors for further pregnancy loss in patients with recurrent miscarriage treated with lymphocyte immunotherapy (LIT).
  
  
  METHODS
  We performed a retrospective observational study of women with a history of two or more consecutive miscarriages who underwent LIT. All patients had undergone investigation of the etiology of the pregnancy losses according to a specific protocol. These etiologic factors were compared between those whose pregnancy outcome was successful and those who had a further miscarriage. The comparison between the groups was performed by Kruskal-Wallis, Fisher exact and Chi-square tests. Perinatal outcome data were collected for the successful pregnancies.
  
  
  RESULTS
  One-hundred six patients were included. The mean number (±SD) of previous pregnancies, deliveries and miscarriages in all patients were 2.73 ± 0.8, 0.19 ± 0.4 and 2.54 ± 0.6, respectively. A successful pregnancy outcome after lymphocyte therapy occurred in 82 patients (group I), while 24 (22.6%) sustained a further miscarriage (group II). There was no statistical difference in the genetic, anatomic and hormonal causes of miscarriage between the groups (p > 0.05). Antinuclear (ANA) and antithyroglobulin (TgAb) autoantibodies occurred more frequently in group II (p = 0.0010 and p = 0.0024, respectively). Of those with successful pregnancies, 11 women (13.4%) had a preterm delivery. The mean birth weight was 3036.4 ± 498.6 g.
  
  
  CONCLUSIONS
  In patients with recurrent miscarriage treated with LIT, the presence of ANA and TgAb was a risk factor for further pregnancy loss. Perinatal outcomes in those whose pregnancies continued were favorable.
authors.affiliation: Department of Gynecology and Obstetrics, University of Fortaleza (UNIFOR) , Fortaleza-CE , Brazil .
authors.forename: Marcelo Borges
authors.initials: MB
authors.lastname: Cavalcante
authors.forename: Fabrício da Silva
authors.initials: Fda S
authors.lastname: Costa
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.forename: Ricardo
authors.initials: R
authors.lastname: Barini
mesh_terms: D000026:Abortion, Habitual / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008214:Lymphocytes; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Lymphocyte immunotherapy; miscarriage; perinatal outcome; recurrent miscarriage; risk factors