Can an autoimmune problem cause recurrent miscarriages?

Abstract:

Objectives:

To determine the role of antiphospholipid antibodies and anticardiolipin antibodies in first-trimester losses, addressing experimental pitfalls that preclude excluding the possibility that these antibodies reflect merely the selection bias of studying couples only after they have already experienced losses.

Design:

Given that retrospective studies cannot exclude the possibility that such antibodies arise as a result of the fetal death, blood samples were obtained either before pregnancy or very early in pregnancy. Sera were obtained within 21 days of conception.

Setting:

Multicenter university-based hospitals (National Institute of Child Health and Human Development collaborative study).

Patients:

Subjects for the current study were 93 women who later experienced pregnancy loss (48 diabetic; 45 nondiabetic), matched 2:1 with 190 controls (93 diabetic and 97 nondiabetic) who subsequently had normal live-born offspring.

Interventions:

Sera from these 283 women were analyzed for antiphospholipid antibodies by enzyme immunoassay. In 260 of the 283 women (87 with pregnancy losses; 173 with live-born infants), sera were also available to perform assays for anticardiolipin antibodies by enzyme immunoassay.

Main Outcome Measure(s):

Pregnancy losses.

Results:

No association was observed between pregnancy loss and the presence of antiphospholipid antibodies or anticardiolipin antibodies. Levels of antiphospholipid antibodies were 6-19 PL/mL in 62.4% of the pregnancies that ended in losses and<=20 PL/mL in 5.4%; among pregnancies resulting in live-born infants, the percentages were 56.8% and 6.8%, respectively. Of the pregnancies that ended in a loss, 5.7% had anticardiolipin antibodies<=16 GPL/mL, compared with 5.2% of those ending in a live birth.

Conclusion(s):

This prospective study suggests that anticardiolipin antibodies and antiphospholipid antibodies are not associated with an increased risk for first-trimester pregnancy loss.

Please click on the required question.

• 1  What is a miscarriage?
• 2  What are the different types of miscarriage?
• 3  How accurate are pregnancy tests?
• 4 What is a blighted ovum?
• 5 I have had a hydatidiform mole. What is this?
• 6 Why did I have a spontaneous miscarriage?
• 7 How frequently do miscarriages occur?
• 8 I am miscarrying. How should this be treated?
• 8a Can miscarriage result in anxiety and depression?
•  9 What is meant by recurrent miscarriage?
• 10 I have a problem with recurrent miscarriage. What is the chance of my next pregnancy being successful?
• Q 12.11 Recurrent Miscarriage I have miscarried again. Why does this keep happening?
• 12 What congenital problems might be associated with recurrent miscarriage and how could they be treated?
• 13 What traumatic conditions can cause recurrent miscarriage and how can they be treated?
• 14 Can infection cause recurrent miscarriage and would treatment help?
• 15 Could a metabolic disorder cause recurrent miscarriage?
• 16 Could a hormonal problem account for recurrent miscarriage and would hormone treatment help me?
• 17 Could an autoimmune problem cause recurrent miscarriage and how could this be treated?
• 18 Could a tumour cause recurrent miscarriage?
• 19 What degenerative processes may be associated with recurrent miscarriage?
• 20 After every miscarriage I become more depressed. Could this account for the problem?
• 21 Is it always possible to explain recurrent miscarriage?
• 22 I have a problem with recurrent miscarriage. What treatment is available to ensure that this does not happen again?
• 23 What is an ectopic pregnancy?
• 24 How frequently do ectopic pregnancies occur?
• 25 Why do ectopic pregnancies occur?
• 26 How can an ectopic pregnancy be diagnosed?
• 27 How can an ectopic pregnancy be treated?
• 28 Where can I obtain more information?
• 29 Support Groups.
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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