First-Trimester Clinical Characteristics and Pregnancy Outcomes in Women with Recurrent Pregnancy Loss
Por:
Trilla, C, Platero, J, Camprubí, N, Mora, J, Luna, C, Oros, D, Llurba, E
Publicada:
16 ago 2025
Resumen:
Objective: To describe first-trimester maternal, biochemical, biophysical, and ultrasound characteristics in women with recurrent pregnancy loss (RPL) compared to women without RPL. Methods: This was a retrospective cohort study analyzing data from 4440 pregnant women, including 142 women with previous RPL. Maternal and pregnancy characteristics, first-trimester biochemical markers, biophysical assessments, early-onset preeclampsia (EOPE) risk, and perinatal outcomes were compared. Results: Women with RPL were older (37.8 vs. 34.0 years, p < 0.001) and had higher rates of antiphospholipid syndrome (4.9% vs. 0.9%, p < 0.001), other thrombophilias (5.6% vs. 0.8%, p < 0.001), and thyroid disorders (14% vs. 7.5%, p = 0.010) than women without RPL. First-trimester uterine artery pulsatility index (UtA-PI) values, pregnancy-associated plasma protein-A (PAPP-A) levels, mean arterial pressure, and final risk for EOPE were comparable between groups. However, the RPL group had higher rates of very high risk for PE (10.6 vs. 5.1, p = 0.011). Likewise, second-trimester UtA-PI was higher in this group (1.10 vs. 1.01, p = 0.045). Aspirin and low molecular weight heparin prophylaxis were more frequent in women with RPL (23.8% vs. 9.6%, p < 0.001; 14.7% vs. 0.1%, p < 0.001). Regarding perinatal outcomes, we found a higher incidence of second-trimester intrauterine demise in the RPL group (6.4% vs. 1.4%, p = 0.011), with no other differences observed in the remaining outcomes. Conclusions: Women with RPL exhibit distinct maternal characteristics and worse pregnancy outcomes, although first-trimester markers do not seem to significantly differ from findings in women without RPL. These findings underscore the importance of tailored screening and intervention protocols to improve perinatal outcomes in this high-risk population.
Filiaciones:
Trilla, C:
Hosp Santa Creu & Sant Pau, Inst Invest Biomed St Pau IIB St Pau, Dept Obstet & Gynecol, Barcelona 08025, Spain
Univ Autonoma Barcelona, Fac Med, Barcelona 08193, Spain
Inst Salud Carlos 3, Spanish Network Maternal Neonatal Child & Dev Hlth, RD24 0013 0001, Madrid 28040, Spain
Inst Recerca IR SANT PAU, Women & Perinatal Hlth Res Grp, St Quinti 77-79, Barcelona 08041, Spain
Platero, J:
Hosp Santa Creu & Sant Pau, Inst Invest Biomed St Pau IIB St Pau, Dept Obstet & Gynecol, Barcelona 08025, Spain
Camprubí, N:
Hosp Santa Creu & Sant Pau, Inst Invest Biomed St Pau IIB St Pau, Dept Obstet & Gynecol, Barcelona 08025, Spain
Mora, J:
Univ Autonoma Barcelona, Fac Med, Barcelona 08193, Spain
Hosp Santa Creu & Sant Pau, Dept Biochem, Barcelona 08025, Spain
Luna, C:
Hosp Clin Univ Lozano Blesa, Aragon Inst Hlth Res IIS Aragon, Obstet Dept, Zaragoza 50009, Spain
Oros, D:
Hosp Clin Univ Lozano Blesa, Aragon Inst Hlth Res IIS Aragon, Obstet Dept, Zaragoza 50009, Spain
Llurba, E:
Hosp Santa Creu & Sant Pau, Inst Invest Biomed St Pau IIB St Pau, Dept Obstet & Gynecol, Barcelona 08025, Spain
Univ Autonoma Barcelona, Fac Med, Barcelona 08193, Spain
Inst Salud Carlos 3, Spanish Network Maternal Neonatal Child & Dev Hlth, RD24 0013 0001, Madrid 28040, Spain
Inst Recerca IR SANT PAU, Women & Perinatal Hlth Res Grp, St Quinti 77-79, Barcelona 08041, Spain
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