Association of Previous Surgical Miscarriage with Risk of Preterm Subsequent Pregnancy in Females Presenting in a Tertiary Care Hospital: Surgical Miscarriages and Preterm Pregnancy

Yasmeen Gul; Aisha Yousaf; Rabia Akram; Rubina Baber; Shabana Khokhar; Bushra Sultana

doi:10.54393/pjhs.v5i07.1844

Authors

Yasmeen Gul Department of Gynaecology and Obstetrics, Makran Medical College, Turbat, Pakistan
Aisha Yousaf Department of Gynaecology and Obstetrics, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan
Rabia Akram Department of Gynaecology, Shalamar Medical and Dental College, Lahore, Pakistan
Rubina Baber Department of Gynaecology and Obstetrics, District Headquarter Teaching Hospital, Dera Ismail Khan, Pakistan
Shabana Khokhar Department of Gynaecology and Obstetrics, Punjab Rangers Teaching Hospital, Lahore, Pakistan
Bushra Sultana Department of Gynaecology and Obstetrics, Fauji Foundation Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i07.1844

Keywords:

Congenital Anomalies, Gestational Age, Surgical Miscarriage, Neonatal Outcomes

Abstract

Surgical miscarriages are a common obstetric issue with potential long-term effects on subsequent pregnancies. Objective: To evaluate the association between previous surgical miscarriages and the risk of preterm birth in later pregnancies. Methods: This descriptive cross-sectional study was conducted at the Department of Obstetrics & Gynaecology, Mekran Medical College (MMC), Turbat, from November 2023 to April 2024. Data collected included age at second pregnancy, BMI, socioeconomic status, smoking status, and medical conditions such as hypertension and diabetes. Collected data were processed and analyzed using IBM SPSS, version 27.0. Results: The study included 230 patients with a history of miscarriage. Participants with ≥ 3 previous miscarriages had significantly higher odds of all-cause preterm birth (OR = 8.19, p = 0.050), spontaneous preterm birth (OR = 6.38, p = 0.005), and induced preterm birth (OR = 4.64, p < 0.001) compared to those with 1 previous miscarriage. After adjustment, those with ≥ 3 previous miscarriages had higher odds of all-cause (OR = 4.92, p < 0.001) and spontaneous preterm birth (OR = 5.79, p = 0.005), but not induced preterm birth (OR = 5.63, p = 0.050). Conclusions: Our study results revealed a significant association between a history of previous surgical miscarriages and the probability of preterm births in subsequent pregnancies. These findings underscore the need for clinical monitoring and interventions for women with a history of surgical miscarriages

References

Alipanahpour S, Tayebi N, Zarshenas M, Akbarzadeh M. Short-term physical and psychological health consequences of induced and spontaneous abortion: a cross-sectional study. Shiraz E-Medical Journal. 2021 Dec; 22(12). doi: 10.5812/semj.111809. DOI: https://doi.org/10.5812/semj.111809

La X, Wang W, Zhang M, Liang L. Definition and multiple factors of recurrent spontaneous abortion. Environment and Female Reproductive Health. 2021; 1300: 231-57. doi: 10.1007/978-981-33-4187-6_11. DOI: https://doi.org/10.1007/978-981-33-4187-6_11

Zhang S, Tang H, Zhou M. Association between previous surgical termination of pregnancy and pregnancy outcomes in frozen-thawed embryo transfer cycles of IVF/ICSI: a retrospective cohort study. Scientific Reports. 2024 Mar; 14(1): 6579. doi: 10.1038/s41598-024-57377-4. DOI: https://doi.org/10.1038/s41598-024-57377-4

De Codt M, Balza C, Jadoul P, Forget P, Squifflet JL, Bernard P et al. Hysteroscopic resection for missed abortion: feasibility, operative technique and potential benefit compared to curettage. Frontiers in Surgery. 2020 Sep; 7: 64. doi: 10.3389/fsurg.2020.00064. DOI: https://doi.org/10.3389/fsurg.2020.00064

Dcunha R, Hussein RS, Ananda H, Kumari S, Adiga SK, Kannan N et al. Current insights and latest updates in sperm motility and associated applications in assisted reproduction. Reproductive Sciences. 2022 Jan; 29(1): 7-25. doi: 10.1007/s43032-020-00408-y. DOI: https://doi.org/10.1007/s43032-020-00408-y

Stewart KT, Lee JS, Pan K, Albert AY, Fisher S. Outcome of using vaginal misoprostol for treatment of retained products of conception after first trimester miscarriage: a retrospective cohort study. The European Journal of Contraception & Reproductive Health Care. 2020 Nov; 25(6): 474-9. doi: 10.1080/13625187.2020.1807498. DOI: https://doi.org/10.1080/13625187.2020.1807498

Nepyivoda OM and Ryvak TB. Threatened miscarriage and pregnancy loss: contemporary aspects of the problem. Wiad Lek. 2020 Jan; 73(5): 1021-7. doi: 10.36740/WLek202005134. DOI: https://doi.org/10.36740/WLek202005134

Meaidi A, Friedrich SJ, Lidegaard. Risk of surgical evacuation and risk of major surgery following second-trimester medical abortion in Denmark: A nationwide cohort study. Contraception. 2020 Sep; 102(3): 201-6. doi: 10.1016/j.contraception.2020.04.017. DOI: https://doi.org/10.1016/j.contraception.2020.04.017

Kakinuma T, Kakinuma K, Kaneko A, Kagimoto M, Kawarai Y, Ihara M et al. Safety and efficacy of manual vacuum aspiration under local anesthesia compared to general anesthesia in the surgical management of miscarriage: a retrospective cohort study. Patient Safety in Surgery. 2022 May; 16(1): 16. doi: 10.1186/s13037-022-00328-7. DOI: https://doi.org/10.1186/s13037-022-00328-7

Liang C, Chung HF, Dobson AJ, Mishra GD. Infertility, miscarriage, stillbirth, and the risk of stroke among women: a systematic review and meta-analysis. Stroke. 2022 Feb; 53(2): 328-37. doi: 10.1161/STROKEAHA.121.036271. DOI: https://doi.org/10.1161/STROKEAHA.121.036271

Pervaiz S, Naeem MA, Ali A, John A, Batool N. Frequency of uterine anomalies associated with persistent miscarriages in pregnancy on ultrasound: Uterine anomalies associated with persistent miscarriages. Pakistan Journal of Health Sciences. 2022 Jun: 55-8. doi: 10.54393/pjhs.v3i01.54. DOI: https://doi.org/10.54393/pjhs.v3i01.54

Quenby S, Gallos ID, Dhillon-Smith RK, Podesek M, Stephenson MD, Fisher J et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. The Lancet. 2021 May; 397(10285): 1658-67. doi: 10.1016/S0140-6736(21)00682-6. DOI: https://doi.org/10.1016/S0140-6736(21)00682-6

Kukulskienė M and Žemaitienė N. Experience of late miscarriage and practical implications for post-natal health care: qualitative study. InHealthcare. 2022 Jan; 10(1): 79. doi: 10.3390/healthcare10010079. DOI: https://doi.org/10.3390/healthcare10010079

Mitrogiannis I, Evangelou E, Efthymiou A, Kanavos T, Birbas E, Makrydimas G et al. Risk factors for preterm birth: an umbrella review of meta-analyses of observational studies. BMC Medicine. 2023 Dec; 21(1): 494. doi: 10.1186/s12916-023-03171-4. DOI: https://doi.org/10.1186/s12916-023-03171-4

Iqbal Z, Jilanee SD, Uppada LP, Imtiaz S, Khan H, Shah SM et al. Evaluating the clinical risk factors associated with miscarriages in women in Karachi, Pakistan. Cureus. 2021 Oct; 13(10). doi: 10.7759/cureus.19057. DOI: https://doi.org/10.7759/cureus.19057

Brown JS, Adera T, Masho SW. Previous abortion and the risk of low birth weight and preterm births. Journal of Epidemiology & Community Health. 2008 Jan; 62(1): 16-22. doi: 10.1136/jech.2006.050369. DOI: https://doi.org/10.1136/jech.2006.050369

Parker W, Broder M, Berek J, Farquhar C, Shoupe D, Liu Z. A Revised Markov Model Evaluating Oophorectomy at the Time of Hysterectomy for Benign Indication: Age 65 Years Revisited. Obstetrics & Gynecology. 2022 Sep; 140(3): 520-1. doi: 10.1097/AOG.0000000000004912.

Rush SK and Rose SL. A Revised Markov Model Evaluating Oophorectomy at the Time of Hysterectomy for Benign Indication: Age 65 Years Revisited Reply. Obstetrics And Gynecology. 2022 Sep; 140(3): 521-2. doi: 10.1097/AOG.0000000000004912. DOI: https://doi.org/10.1097/AOG.0000000000004912

Wen T, Schmidt CN, Sobhani NC, Guglielminotti J, Miller EC, Sutton D et al. Trends and outcomes for deliveries with hypertensive disorders of pregnancy from 2000 to 2018: A repeated cross‐sectional study. BJOG: An International Journal of Obstetrics & Gynaecology. 2022 Jun; 129(7): 1050-60. doi: 10.1111/1471-0528.17038. DOI: https://doi.org/10.1111/1471-0528.17038

Gascoigne EL, Roell KR, Eaves LA, Fry RC, Manuck TA. Accelerated epigenetic clock aging in maternal peripheral blood and preterm birth. American Journal Of Obstetrics And Gynecology. 2024 May; 230(5): 559-e1. doi: 10.1016/j.ajog.2023.09.003. DOI: https://doi.org/10.1016/j.ajog.2023.09.003