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Pregnancy

Miscarrying women can also have successful pregnancy (Daily News & Analysis-1 June 2010)

Washim: There's good news for women who have gone through multiple miscarriages and all the pain it
entails.

Even among the more than 80% who've had two or more miscarriages will eventually have a successful
pregnancy with supportive care.

Although miscarriage is common -- 30% of all women will experience at least one miscarriage in their
lifetime, and one to two percent will have three or more -- there have been relatively few well-conducted
studies on its causes and treatments, said Ruth Lathi.

Lathi is assistant professor of obstetrics and gynaecology at Stanford University Medical Centre.

“We can do better than this. We need more research,” she said. As many as 40 to 50% of miscarriages
have no identifiable cause.

Some of the causes of miscarriages have been pinpointed. Endocrine problems such as thyroid disease are
responsible for 15-20 percent of miscarriages.

- Hypercoagulability, an increased tendency to develop blood clots, also causes 15-20%; maternal
abnormalities in the uterus or cervix cause 10-15%.

- Maternal genetic mutation causes 2-5%; and in 0.5-5% of cases, infection triggers a miscarriage. Older
age and a history of previous miscarriages also increase the risk.

Some of these causes can be detected and treated. For women with thyroid dysfunction (hypothyroidism
or hyperthyroidism), successful treatment reduces the risk of miscarriage and other adverse outcomes.
Recent studies have also shown that in selected women who have anti-thyroid antibodies (a condition
affecting about 11% of reproductive-age women), treatment with the thyroid hormone levothyroxine can
effectively decrease miscarriage rates.

Women who have hypercoagulability can be treated with therapies that interfere with blood clot
formation, most commonly aspirin or heparin or both.

Weight is another contributing factor, said Sun Kim, MD, assistant professor of medicine at Stanford.

Research finds that being obese or underweight significantly increases pregnancy complications and the
risk of miscarriage, said a Stanford release.

Given that one-third of Americans are obese, the impact of obesity on pregnancy outcomes is a growing
public-health concern, Kim said.

“Losing weight is hard, I don't deny that,” she said. But she added that even moderate weight loss of 5-10
percent can significantly reduce the risk of miscarriage.