October 18th, 2018

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Analysis of the Etiological Factors of Recurrent Spontaneous Abortions in Patients of Advanced Maternal Age
Authors:  Yukun Liu, M.D., Yinglin Liu, M.D., Hui Chen, M.D., Meilan Liu, M.D., and Jianping Zhang, M.D.
  OBJECTIVE: To investigate the etiological factors associated with recurrent spontaneous abortion (RSA) in patients of advanced maternal age.

STUDY DESIGN: We retrospectively analyzed the medical records of RSA patients of advanced maternal age who were treated in our hospital and analyzed the etiological factor distributions in 82 patients who underwent systematic etiological examination and embryonic karyotype analysis after curettage. We also compared the incidence of embryonic karyotype abnormalities between RSA patients of advanced maternal age and patients who experienced sporadic abortions.

RESULTS: The incidence of embryonic karyotype abnormalities was higher in patients of advanced maternal age with sporadic abortion (85.1%) than in RSA patients (67.1%) (p<0.05). Embryonic karyotype abnormality was the main cause of RSA in patients of advanced maternal age (67.1%), followed by uterine abnormalities (19.5%), endocrine factors (17.1%), positive antiphospholipid antibodies (12.2%), and chromosomal abnormalities in the couple (3.7%); recurrent abortions with truly unidentified causes accounted for 17.1% of all cases. Etiological factor distributions did not significantly differ between primary and secondary abortions or among RSA patients who had undergone different numbers of abortions.

CONCLUSION: Embryonic karyotype abnormality is the main cause of RSA in pa-
tients of advanced maternal age. Thyroid function should be retested in early pregnancy for RSA patients.
Keywords:  abnormal karyotype; abortion, habitual; abortion, recurrent; chorionic villi; chorionic villus; chorionic villus sampling; etiologic factors; karyotype; karyotype analysis; maternal age; miscarriage; miscarriage, recurrent; recurrent spontaneous abortion; spontaneous abortion
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