Infectious processes: an infrequent cause of first trimester spontaneous abortions |
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| Authors: | Simpson, Joe Leigh Mills, James L. Kim, Haesook Holmes, Lewis B. Lee, Jack Metzger, Boyd Knopp, Robert Jovanovic-Peterson, Lois Aarons, Jerome Conley, Mary |
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| Affiliation: | 1 Department of Obstetrics and Gynecology, Department of Molecular and Human Genetics, Baylor College of Medicine Houston, TX 2 Department of Obstetrics and Gynecology, University of Tennessee Memphis, Memphis, TN 3 Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development Bethesda, MD 4 Department of Obstetrics and Gynecology, Brigham and Woman's Hospital Boston, MA 5 Department of Medicine, Northwestern University Chicago IL 6 Department of Medicine, University of Washington Seattle, WA 7 Sansum Medical Research Foundation Santa Barbara, CA 8 Department of Medicine, Magee Woman's Hospital, University of Pittsburgh Pittsburgh, PA, USA |
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| Abstract: | A systematic assessment of infections beginning early in pregnancyis necessary to determine the true role of infections in pregnancyloss, given that infections could readily arise only after fetaldemise. To this end, we have prospectively determined the frequencyof infections in pregnant women who were subjects in a multi-centreUS study. Insulin-dependent diabetic subjects and controlledsubjects were recruited either before conception (86%) or atthe latest within 21 days of conception (14%). We collecteddata prospectively on all important risk factors and potentialconfounding variables, seeing 386 diabetic subjects weekly and432 control subjects every other week during the first trimester.At each visit we inquired about untoward events and explicitlyabout fever or infections. We found no clinical evidence thatinfection occurred more often in the 116 subjects experiencingpregnancy loss as compared to the 702 having successful pregnancies.This held both for the 2 week interval in which a given losswas recognized clinically as well as in the prior 2 week interval.Similar findings were not only observed for both the controlas well as diabetic subjects but also when data were stratifiedby genital infection only or by systemic infection only. Ourprospective data suggest that the attributable risk of infectionin first trimester spontaneous abortion is small. |
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| Keywords: | spontaneous abortion/first trimester losses/infectious processes |
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