Pregnancy outcome following a second-trimester loss.

OBJECTIVE

To evaluate the association between fetal loss in the second trimester and subsequent adverse birth outcomes.

METHODS

We identified 95 women in our system who had a pregnancy loss at 13-24 weeks in the years 1985-1990 and tabulated the rates of preterm delivery, stillbirth, and neonatal death in the next pregnancy. We compared these outcomes to two groups: women who delivered at 25-36 weeks in their index pregnancy and those who delivered at term in their index pregnancy.

RESULTS

Thirty-nine percent of women who had a pregnancy loss at 13-24 weeks in the index pregnancy had a preterm delivery in their next pregnancy, 5% had a stillbirth, and 6% had a neonatal death, with all outcomes worse than those found in the two control populations. Delivery at 19-22 weeks in the index pregnancy was associated with a 62% preterm delivery rate in the subsequent pregnancy.

CONCLUSION

A second-trimester loss, especially one occurring at 19-22 weeks, is associated with a poor prognosis in the subsequent pregnancy.