Reproductive outcome after chromosome analysis in couples with two or more miscarriages: case-control study
- 22 February 2006
- Vol. 332 (7544), 759-763
- https://doi.org/10.1136/bmj.38735.459144.2f
Abstract
Objective To compare reproductive outcomes in couples carrying a structural chromosome abnormality and non-carrier couples referred for chromosome analysis after two or more miscarriages. Design Case-control study. Setting Six centres for clinical genetics in the Netherlands. Participants 278 carrier couples and 427 non-carrier couples referred for chromosome analysis between 1992 and 2000 after two or more miscarriages before 20 weeks of gestation. Couples were followed up for at least 24 months after chromosome analysis. Main outcome measures The birth of at least one healthy child, at least one more miscarriage, and viable offspring with unbalanced chromosomal abnormalities after parental chromosome analysis. Results Mean follow-up after chromosome analysis was 5.8 years. 120 of 247 (49%) carrier couples had one or more miscarriage after chromosome analysis compared with 122 of 409 (30%) non-carrier couples (difference 19%, 95% confidence interval 11% to 26%; P < 0.01). The percentage of couples with at least one healthy child was not significantly different in carrier couples (83%) and non-carrier couples (84%) (difference −1%, - 7% to 5%). Among 550 pregnancies in carrier couples, two viable unbalanced chromosome abnormalities were detected at prenatal diagnosis (0.4%) and the fetuses aborted and two children with an unbalanced karyotype were born (0.4%). Conclusions Couples whose carrier status was ascertained after two or more miscarriages have a low risk of viable offspring with unbalanced chromosomal abnormalities. Their chances of having a healthy child are as high as non-carrier couples, despite a higher risk of miscarriage.This publication has 17 references indexed in Scilit:
- Selective chromosome analysis in couples with two or more miscarriages: case-control studyBMJ, 2005
- Poor prognosis of recurrent aborters with either maternal or paternal reciprocal translocationsFertility and Sterility, 2004
- ACOG PRACTICE BULLETIN: NO 24, FEB 2001, MANAGEMENT OF RECURRENT EARLY PREGNANCY LOSSInternational Journal of Gynecology & Obstetrics, 2002
- Outcome of preimplantation genetic diagnosis of translocationsFertility and Sterility, 2000
- Risk estimates for balanced reciprocal translocation carriers — prenatal diagnosis experienceClinical Genetics, 1996
- Pregnancy: An informative protocol for the investigation of recurrent miscarriage: preliminary experience of 500 consecutive casesHuman Reproduction, 1994
- Logistic regression model to estimate the risk of unbalanced offspring in reciprocal translocationsHuman Genetics, 1993
- Cytogenetic studies in couples experiencing repeated pregnancy lossesHuman Reproduction, 1990
- Risks of unbalanced progeny at amniocentesis to carriers of chromosome rearrangements: Data from United States and Canadian laboratoriesAmerican Journal of Medical Genetics, 1989
- Karyotypes of 1142 couples with recurrent abortion.1988