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Clinical Obstetrics

Poster Session 3

(740) Maternal history of recurrent pregnancy loss and placental related complications

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Gil Gutvirtz, MD

    Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Metar, HaDarom, Israel

    • Coauthor(s)

  • Gali Pariente, MD

    Acting director of Fetal Maternal Unit B Division of Obstetrics and Gynecology
    Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Klahim, HaDarom, Israel

  • Tamar Wainstock, PhD (she/her/hers)

    Ben Gurion University
    Beer-Sheva, HaDarom, Israel

  • Eyal Sheiner, MD, PhD

    Head of department of Obstetrics and Gynecology B, Soroka University Medical Center
    Soroka University Medical Center
    Beer-Sheva, HaDarom, Israel

Objective: Recurrent pregnancy loss (RPL) is a complex condition in which hematologic, endocrine and immunologic disorders have been identified as contributing factors. These disorders are also associated with suboptimal implantation and placentation. Hence, we sought to investigate whether maternal history of RPL is associated with placental-related complications in pregnancy.

Study Design: A retrospective population-based cohort study of singleton deliveries was conducted to evaluate placental-related complications, including hypertensive disorders of pregnancy (gestational hypertension and preeclampsia), intra-uterine growth restriction (IUGR), placental abruption, placenta previa and preterm delivery, in mothers with and without a history of RPL. Generalized estimating equation (GEE) models were used to control for potential confounders.

Results: During the 30 years (1991-2021) study period, 356,356 singleton deliveries occurred; 14,235 deliveries (4.0%) occurred in women with a history of RPL. Placental complications were significantly more prevalent following RPL, including placental abruption, placenta previa and preterm delivery (Table). Using GEE models, controlling for siblings, maternal age, hypertensive disorders of pregnancy, pre-gestational and gestational diabetes mellitus, smoking and fertility treatments, maternal history of RPL was independently associated with IUGR, placental abruption, placenta previa and preterm delivery (Table).

Conclusion: Maternal history of RPL is an independent risk factor for placental-related complications in pregnancy, unrelated to maternal hypertensive disorders. Thus, emphasizing the need for specialized care and monitoring of these women.