4.2 Article

A proposed prognostic prediction tool for a live birth among women with recurrent pregnancy loss

Journal

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Volume 35, Issue 19, Pages 3736-3742

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14767058.2020.1839877

Keywords

Recurrent pregnancy loss; prognostic tool; RPL workup; primary RPL; secondary RPL

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This retrospective cohort study aimed to develop a prognostic tool for predicting live birth rate in cases of repeated pregnancy losses. Data from 675 patients treated in a dedicated clinic between 2000 and 2015 were used to construct two prediction models. The results showed significant associations between live birth rate and factors such as age, number of previous pregnancy losses, primary/secondary RPL, and positive RPL workup. The tool can provide accurate information to couples and healthcare providers, reducing patient stress and allowing for personalized intervention programs.
Purpose To develop a prognostic tool to predict the live birth rate in cases of repeated pregnancy losses. Study design A retrospective cohort study including patients treated in the dedicated RPL clinic between 2000 and 2015. Background data was collected in the primary visit via questionnaires and medical records. The repeated pregnancy loss workup includes a genetic testing, endocrine testing, and anatomic abnormalities as well as thrombophilia.The prognostic tool took into account the unique contribution of the different risk factors, including maternal age, number of pregnancy losses, primary vs. secondary RPL and positive RPL workup. Results A total of 675 women were included in the study the live birth rate was 72% (484). It was significantly associated with age (p=.002), number of previous pregnancy losses (p=.016), primary and secondary RPL and positive RPL workup. Each variable was assigned points according to the odds ratio found in the logistic regression to create two prediction models, before and after the RPL workup. Both models show a rise in the live birth rate as the score increases. Conclusions We constructed a proposed innovative prognostic tool to predict the chance of a live birth on the consecutive pregnancy following the visit to the RPL clinic. Locating, identifying and improving risk assessment can enable the provision of up-to-date information to couples and the treating staff. This knowledge will reduce stress among the patients and will allow the staff to constructed custom intervention programs.

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