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      How many missed abortions are caused by embryonic chromosomal abnormalities and what are their risk factors?

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          Abstract

          Introduction: Though embryonic chromosome abnormalities have been reported to be the most common cause of missed abortions, previous studies have mainly focused on embryonic chromosome abnormalities of missed abortions, with very few studies reporting that of non-missed abortion. Without chromosome studies of normal abortion samples, it is impossible to determine the risk factors of embryo chromosome abnormalities and missed abortion. This study aimed to investigate the maternal and embryonic chromosome characteristics of missed and non-missed abortion, to clarify the questions that how many missed abortions are caused by embryonic chromosomal abnormalities and what are their risk factors.

          Material and methods: This study was conducted on 131 women with missed or non-missed abortion from the Longitudinal Missed Abortion Study (LoMAS). Logistic regression analysis was used to identify the association between maternal covariates and embryonic chromosomal abnormalities and missed abortions. Data on the characteristics of women with abortions were collected.

          Results: The embryonic chromosome abnormality rate was only 3.9% in non-missed abortion embryos, while it was 64.8% in missed-abortion embryos. Assisted reproductive technology and prior missed abortions increased the risk of embryonic chromosome abnormalities by 1.637 (95% CI: 1.573, 4.346. p = 0.010) and 3.111 (95% CI: 1.809, 7.439. ( p < 0.001) times, respectively. In addition, as the age increased by 1 year, the risk of embryonic chromosome abnormality increased by 14.4% (OR: 1.144, 95% CI: 1.030, 1.272. p = 0.012). Moreover, advanced age may lead to different distributions of chromosomal abnormality types.

          Conclusion: Nearly two-thirds of missed abortions are caused by embryonic chromosomal abnormalities. Moreover, advanced age, assisted reproductive technology, and prior missed abortions increase the risk of embryonic chromosomal abnormalities.

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          The majority of miscarriages are sporadic and most result from genetic causes that are greatly influenced by maternal age. Recurrent pregnancy loss (RPL) is defined by two or more failed clinical pregnancies, and up to 50% of cases of RPL will not have a clearly defined etiology. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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            Recurrent pregnancy loss: evaluation and treatment.

            Lora Shahine, Ruth Lathi (2015)
            Recurrent pregnancy loss (RPL) is a multifactorial condition. Approximately half of patients with RPL will have no explanation for their miscarriages. De novo chromosome abnormalities are common in sporadic and recurrent pregnancy loss. Testing for embryonic abnormalities can provide an explanation for the miscarriage in many cases and prognostic information. Regardless of the cause of RPL, patients should be reassured that the prognosis for live birth with an evidence-based approach is excellent for most patients. The authors review current evidence for the evaluation and treatment of RPL and explore the proposed use of newer technology for patients with RPL.
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              Sex reduces genetic variation: a multidisciplinary review.

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              For over a century, the paradigm has been that sex invariably increases genetic variation, despite many renowned biologists asserting that sex decreases most genetic variation. Sex is usually perceived as the source of additive genetic variance that drives eukaryotic evolution vis-à-vis adaptation and Fisher's fundamental theorem. However, evidence for sex decreasing genetic variation appears in ecology, paleontology, population genetics, and cancer biology. The common thread among many of these disciplines is that sex acts like a coarse filter, weeding out major changes, such as chromosomal rearrangements (that are almost always deleterious), but letting minor variation, such as changes at the nucleotide or gene level (that are often neutral), flow through the sexual sieve. Sex acts as a constraint on genomic and epigenetic variation, thereby limiting adaptive evolution. The diverse reasons for sex reducing genetic variation (especially at the genome level) and slowing down evolution may provide a sufficient benefit to offset the famed costs of sex. © 2010 The Author(s). Evolution© 2010 The Society for the Study of Evolution.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Genet
                Journal ID (iso-abbrev): Front Genet
                Journal ID (publisher-id): Front. Genet.
                Title: Frontiers in Genetics
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-8021
                Publication date (Electronic): 04 January 2023
                Publication date Collection: 2022
                Volume: 13
                Electronic Location Identifier: 1058261
                Affiliations
                [1] 1 Chengdu Women’s and Children’s Central Hospital , School of Medicine , University of Electronic Science and Technology of China , Chengdu, China
                [2] 2 Chengdu University of Traditional Chinese Medicine , Chengdu, China
                [3] 3 West China Second University Hospital , West China Women’s and Children’s Hospital , Chengdu, China
                [4] 4 Chengdu Jinniu Maternal and Child Health Care Hospital , Chengdu, China
                [5] 5 The Eighth Affiliated Hospital of Sun Yat Sen University , Shenzhen, China
                Author notes

                Edited by: Henry H. Heng, Wayne State University, United States

                Reviewed by: Hamid Gourabi, Royan Institute, Iran

                Aleksandar Ljubić, BioCell Hospital, Serbia

                *Correspondence: Kangmu Lu, kangmolu@ 123456qq.com ; Ying Xiong, 469761447@ 123456qq.com
                [ † ]

                These authors have contributed equally to this work

                This article was submitted to Human and Medical Genomics, a section of the journal Frontiers in Genetics

                Article
                Publisher ID: 1058261
                DOI: 10.3389/fgene.2022.1058261
                PMC ID: 9846508
                SO-VID: 1f63a127-256a-440c-8c53-fb67c2a283d6
                Copyright © Copyright © 2023 Li, Kang, Yin, Liu, Hou, Yu, Guo, Shen, Ge, Zeng, Lu and Xiong.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 30 September 2022
                Date accepted : 08 December 2022
                Categories
                Subject: Genetics
                Subject: Original Research

                ScienceOpen disciplines: Genetics
                Keywords: missed abortion,chromosome abnormality,assisted reproductive technology,advanced age,gene
                Data availability:
                ScienceOpen disciplines: Genetics
                Keywords: missed abortion, chromosome abnormality, assisted reproductive technology, advanced age, gene

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