Dataset Information

The association of euploid miscarriage with obesity.

ABSTRACT:

Objective

To determine whether the frequency of euploid miscarriage is increased in obese women with early pregnancy loss.

Design

Retrospective cohort study.

Setting

Academic medical center.

Patients

A total of 2,620 women with cytogenetic analysis results from products of conception after a pregnancy loss <20 weeks gestation from 2006-2018.

Interventions

None.

Main outcome measures

Frequency of euploid miscarriage was compared in obese (body mass index [BMI] ≥30 kg/m²) versus non-obese (BMI <30 kg/m²) patients.

Results

A total of 2,620 women with a mean (± standard deviation) age at time of loss of 34.9 years (± 4.9) and mean (± standard deviation) BMI of 25.3 kg/m² (±5.5) were included in the final analysis. After adjusting for age and race, obese women were 56% more likely to have a euploid pregnancy loss compared with nonobese women (odds ratio 1.56; 95% confidence interval 1.32-1.92). Within the cohort, 63.8% of the losses were aneuploid, of which 41% were trisomies, 8% were monosomies, and 7% were polyploidies. Of the euploid losses, 50.1% were 46,XX and 49.9% were 46,XY, which suggests that the rate of maternal cell contamination was low.

Conclusions

Obese women have an increased frequency of euploid miscarriage when compared with nonobese women.

SUBMITTER: Lee JC

PROVIDER: S-EPMC8244338 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The association of euploid miscarriage with obesity.

Lee Jacqueline C JC Bernardi Lia A LA Boots Christina E CE

F&S reports 20200928 2

<h4>Objective</h4>To determine whether the frequency of euploid miscarriage is increased in obese women with early pregnancy loss.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>Academic medical center.<h4>Patients</h4>A total of 2,620 women with cytogenetic analysis results from products of conception after a pregnancy loss <20 weeks gestation from 2006-2018.<h4>Interventions</h4>None.<h4>Main outcome measures</h4>Frequency of euploid miscarriage was compared in obese (body mass index ...[more]

PMID: 34223230

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Project description:ObjectiveTo characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first and second trimester miscarriages.DesignNested case-control study.SettingQueen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London.Population161 pregnancies: 64 resulting in first trimester miscarriage, 14 in second trimester miscarriage and 83 term pregnancies.MethodsProspective profiling and comparison of vaginal bacteria composition using 16S rRNA gene-based metataxonomics from 5 weeks' gestation in pregnancies ending in miscarriage or uncomplicated term deliveries matched for age, gestation and body mass index.Main outcome measuresRelative vaginal bacteria abundance, diversity and richness. Pregnancy outcomes defined as first or second trimester miscarriage, or uncomplicated term delivery.ResultsFirst trimester miscarriage associated with reduced prevalence of Lactobacillus spp.-dominated vaginal microbiota classified using hierarchical clustering analysis (65.6 versus 87.7%; P = 0.005), higher alpha diversity (mean Inverse Simpson Index 2.5 [95% confidence interval 1.8-3.0] versus 1.5 [1.3-1.7], P = 0.003) and higher richness 25.1 (18.5-31.7) versus 16.7 (13.4-20), P = 0.017), compared with viable pregnancies. This was independent of vaginal bleeding and observable before first trimester miscarriage diagnosis (P = 0.015). Incomplete/complete miscarriage associated with higher proportions of Lactobacillus spp.-depleted communities compared with missed miscarriage. Early pregnancy vaginal bacterial stability was similar between miscarriage and term pregnancies.ConclusionsThese findings associate the bacterial component of vaginal microbiota with first trimester miscarriage and indicate suboptimal community composition is established in early pregnancy. While further studies are required to elucidate the mechanism, vaginal bacterial composition may represent a modifiable risk factor for first trimester miscarriage.Tweetable abstractVaginal bacterial composition in first trimester miscarriage is associated with reduced Lactobacillus spp. abundance and is independent of vaginal bleeding.

Project description:ObjectivesTo evaluate the association between thyroid autoantibodies and miscarriage and preterm birth in women with normal thyroid function. To assess the effect of treatment with levothyroxine on pregnancy outcomes in this group of women.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, Cochrane Library, and SCISEARCH (inception-2011) without any language restrictions. We used a combination of key words to generate two subsets of citations, one indexing thyroid autoantibodies and the other indexing the outcomes of miscarriage and preterm birth.Study selectionStudies that evaluated the association between thyroid autoantibodies and pregnancy outcomes were selected in a two stage process. Two reviewers selected studies that met the predefined and explicit criteria regarding population, tests, and outcomes.Data synthesisOdds ratios from individual studies were pooled separately for cohort and case-control studies with the random effects model.Results30 articles with 31 studies (19 cohort and 12 case-control) involving 12,126 women assessed the association between thyroid autoantibodies and miscarriage. Five studies with 12,566 women evaluated the association with preterm birth. Of the 31 studies evaluating miscarriage, 28 showed a positive association between thyroid autoantibodies and miscarriage. Meta-analysis of the cohort studies showed more than tripling in the odds of miscarriage with the presence of thyroid autoantibodies (odds ratio 3.90, 95% confidence interval 2.48 to 6.12; P < 0.001). For case-control studies the odds ratio for miscarriage was 1.80, 1.25 to 2.60; P = 0.002). There was a significant doubling in the odds of preterm birth with the presence of thyroid autoantibodies (2.07, 1.17 to 3.68; P = 0.01). Two randomised studies evaluated the effect of treatment with levothyroxine on miscarriage. Both showed a fall in miscarriage rates, and meta-analysis showed a significant 52% relative risk reduction in miscarriages with levothyroxine (relative risk 0.48, 0.25 to 0.92; P=0.03). One study reported on the effect of levothyroxine on the rate of preterm birth, and noted a 69% relative risk reduction (0.31, 0.11 to 0.90).ConclusionThe presence of maternal thyroid autoantibodies is strongly associated with miscarriage and preterm delivery. There is evidence that treatment with levothyroxine can attenuate the risks.

Dataset Information

The association of euploid miscarriage with obesity.

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Conclusions

Publications

The association of euploid miscarriage with obesity.

Similar Datasets

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