Frequency of euploid miscarriage is increased in obese women with recurrent early pregnancy loss

Abstract

Objective: To determine whether the frequency of euploid miscarriage is increased in obese women with recurrent early pregnancy loss (REPL).

Design: Observational cohort study using prospectively collected data.

Setting: Academic RPL program.

Patient(s): A total of 372 women with REPL, defined as ≥2 pregnancy losses<10 weeks, and at least one ultrasound-documented miscarriage with chromosome results.

Intervention(s): Body mass index (BMI) was measured at the initial consultation and at each subsequent pregnancy. Conventional cytogenetic analysis and, when indicated, microsatellite analysis and/or comparative genomic hybridization was performed.

Main outcome measure(s): Frequency of euploid miscarriage in obese (BMI≥30 kg/m2) and nonobese (BMI<30 kg/m2) subjects, before and subsequent to REPL evaluation.

Result(s): There were 578 miscarriages with chromosome results. Of the subjects, 18% were obese at the time of miscarriage. The mean maternal age at miscarriage was similar between the obese and nonobese groups. Due to the high rate of maternal cell contamination in the prior miscarriages, only subsequent miscarriages with chromosome results were included in the primary analysis. Of the 117 subsequent miscarriages, the frequency of an euploid miscarriage among obese women was 58% compared with 37% of nonobese women (relative risk=1.63; 95% confidence interval 1.08-2.47).

Conclusion(s): Obese women with REPL have an increased frequency of euploid miscarriage, which is a known risk factor for subsequent miscarriage.

Keywords: Obesity; euploid; karyotype; recurrent miscarriage; recurrent pregnancy loss.