PREDICTIVE FACTORS IN RECURRENT SPONTANEOUS ABORTERS - A MULTICENTER STUDY

PROBLEM: Compare data from several centers relating to success rates i n recurrent spontaneous miscarriage and assess the significance of ind icators of subsequent pregnancy loss. METHOD: Data from 777 couples wi th unexplained recurrent spontaneous abortion from independent studies at seven centers were analyzed using logistic regression analysis. Th e following covariates were considered: age of patient, number of prev ious spontaneous abortions, length of previous abortions history, sub- fertility index (defined as the product of the number of spontaneous a bortions and the abortion history), whether a patient was a primary or secondary aborter, and whether a patient had received leukocyte immun otherapy. RESULTS: There was a highly significant difference between t he seven centers in success rates in the subsequent pregnancy and a hi ghly significant association between success rate and each of the foll owing covariates: the number of previous abortions, the length of the previous abortion history and the sub-fertility index. In particular, for each increase of 10 units in the value of the sub-fertility index, up to a value of 30, the odds in favor of a successful pregnancy decr eased by a factor of 0.6, i.e., 40%. There was, however, little eviden ce of an association between the success rate in the subsequent pregna ncy and age, parity, or immunization with cells from the husband. CONC LUSIONS: The sub-fertility index may be a useful measure of likelihood of success in a subsequent pregnancy.