Family history and risk of miscarriage: a systematic review and meta-analysis of observational studies

Andrea MF Woolner* (Corresponding Author), Priti Nagdeve, Edwin Amalraj Raja, Siladitya Bhattacharya, Sohinee Bhattacharya

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Introduction
Miscarriage, a spontaneous pregnancy loss at less than 24 weeks gestation, is a common complication of pregnancy but the aetiologies of miscarriage and recurrent miscarriage are not fully understood. Other obstetric conditions such as pre‐eclampsia and preterm birth, which may share similar pathophysiology to miscarriage, exhibit familial patterns suggesting inherited predisposition to these conditions. Parental genetic polymorphisms have been associated with unexplained miscarriage therefore suggesting there could be a genetically inherited predisposition to miscarriage. This systematic review and meta‐analysis of observational studies aimed to assess the association between family history of miscarriage and the risk of miscarriage in women.

Material and Methods
A systematic review and meta‐analysis of observational studies was carried out in accordance with MOOSE guidelines. Electronic searches using databases (Medline, EMBASE, CINAHL) were carried out to identify eligible studies from 1946 until 2019. Observational studies (cohort or case‐control) were included. Human studies only were included. Participants were women of reproductive age. Exposure was a family history of one or more miscarriage(s). The primary outcome was miscarriage in women. Abstracts were screened and data were extracted by two independent reviewers. Study quality was assessed using Critical Appraisal Skills Program (CASP) tools. Data were pooled from individual studies using Mantel‐Haenszel method to produce pooled Odds Ratios (ORs) with 95% confidence intervals (95%CI). Systematic review registration number (PROSPERO): CRD42019127950.

Results
Thirteen studies were identified in the systematic review; ten were eligible for inclusion in the meta‐analysis. Twelve studies reported an association between family history of miscarriage and miscarriage in women. 41,287 women were included in the meta‐analysis. Women who miscarried were more likely to report a family history of miscarriage (pooled unadjusted OR 1.90; 95%CI 1.37 to 2.63). Overall study quality and size varied, with few adjusting for confounding factors. Results should be interpreted with caution as the associations presented are based on unadjusted analyses only.

Conclusions
Women who miscarry may be more likely to have a family history of miscarriage. Further research is required to confirm or refute the findings.
Original languageEnglish
JournalActa Obstetricia et Gynecologica Scandinavica
Early online date18 Jun 2020
DOIs
Publication statusE-pub ahead of print - 18 Jun 2020

Keywords

  • familial
  • family history
  • inherited
  • miscarriage
  • predisposition
  • recurrent miscarriage
  • Miscarriage

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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