WASHINGTON: 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% 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 percent 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% can significantly reduce the
risk of miscarriage.
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