title: Association between a Maternal History of Miscarriages and Birth Defects.
abstract: BACKGROUND
  Some studies, mainly in the older literature, observed a significant association between miscarriages and birth defects (BDs) occurring in the same sibship. However, few studies examined the BD/miscarriage relationship in depth. In addition nothing has been added to the underlying mechanisms possibly linking both events. The purpose of this work was to identify specific BDs associated with maternal miscarriages. In particular, it examined whether the risk depended on the number of losses, and to suggest the existence of specific factors for each BD/miscarriage association observed.
  
  
  METHODS
  The study relied on the Latin American Collaborative Study on Congenital Malformations (ECLAMC) database registries including 26,906 live and stillborn infants with one of 19 selected isolated BDs and 93,853 normal controls. Infants born to primigravid mothers were excluded from the present study. Demographic and reproductive variables were compared between control mothers With and Without previous miscarriages. The number, frequency, and distribution of miscarriages were observed for each BD and controls. A conditional logistic regression was applied to evaluate the miscarriage risk for each BD.
  
  
  RESULTS
  Control mothers with previous miscarriages were older, had had more pregnancies, and were less educated. Three risk patterns of miscarriages were observed: a very high risk of miscarriages associated with gastroschisis, omphalocele, and talipes; only one miscarriage associated with spina bifida, and two or more miscarriages associated with hypospadias.
  
  
  CONCLUSIONS
  These three patterns suggest that different factors underly each BD/miscarriage association: infertility for hypospadias, vascular disruption for gastroschisis and talipes, while for spina bifida, the much debated trophoblastic cell residue theory could not be discarded. Birth Defects Research 109:254-261, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Hebe
authors.initials: H
authors.lastname: Campaña
authors.affiliation: ECLAMC at Hospital Materno Infantil Ramón Sardá, University of Buenos Aires.
authors.forename: Monica
authors.initials: M
authors.lastname: Rittler
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Gili
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Poletta
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Mariela S
authors.initials: MS
authors.lastname: Pawluk
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Lucas G
authors.initials: LG
authors.lastname: Gimenez
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Viviana R
authors.initials: VR
authors.lastname: Cosentino
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Eduardo E
authors.initials: EE
authors.lastname: Castilla
authors.affiliation: Latin American Collaborative Study of Congenital Malformations (ECLAMC) at Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina.
authors.forename: Jorge S López
authors.initials: JS
authors.lastname: Camelo
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D000367:Age Factors; D001118:Argentina / Q000453:epidemiology; D016022:Case-Control Studies; D016208:Databases, Factual; D004522:Educational Status; D005260:Female; D020139:Gastroschisis / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D020073:Gravidity / Q000502:physiology; D006554:Hernia, Umbilical / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D010298:Parity / Q000502:physiology; D011247:Pregnancy; D012042:Registries; D012306:Risk; D016135:Spinal Dysraphism / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D013223:Statistics as Topic; D050497:Stillbirth / Q000453:epidemiology; D000070558:Talipes / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology
keywords: ECLAMC; club foot; gastroschisis; hypospadias; miscarriage; omphalocele; spina bifida; talipes