828: Maternal history of recurrent pregnancy loss increases the risk for long term paediatric neurological morbidity of the offspring

Abstract

Maternal recurrent pregnancy loss may represent a significant underlying pathology. We sought to investigate whether maternal history of recurrent pregnancy loss (RPL) is associated with long-term neurological morbidity of the offspring. A population based cohort analysis was performed comparing the risk of long-term neurological morbidity (up to the age of 18 years) of children born to mothers diagnosed with RPL (defined as two or more failed clinical pregnancies). Offspring of women previously diagnosed with RPL were compared to offspring of women without such diagnosis. Neurological morbidity included hospitalizations involving a pre-defined set of ICD-9 codes, as recorded in the medical records. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies and fetal congenital malformations were excluded. A Kaplan-Meier survival curve was constructed to compare cumulative neurological morbidity. A Cox proportional hazards model was used to control for confounders. During the study period, 242 187 newborns met the inclusion criteria; 5% (n=12182) of which were offspring to mothers with a history of RPL. Neurological morbidity was significantly more common in the exposed group (3.6% vs. 3.1%, p=0.002, Table). Specifically, offspring to mothers with a history of RPL had higher rates of developmental and movement disorders (p<0.001). The Kaplan-Meier survival curve exhibited a higher cumulative incidence of total neurological morbidity (Log rank p=0.004, Figure). In the Cox regression, maternal history of RPL was independently associated with increased pediatric neurological morbidity of the offspring while adjusting for multiple confounders including gestational age, birthweight, maternal gestational diabetes and hypertensive disorders in pregnancy (aHR 1.14, 95% CI 1.03 - 1.25, p=0.011). Maternal history of recurrent pregnancy loss is associated with a higher risk of future pediatric neurological morbidity of the offspring.View Large Image Figure ViewerDownload Hi-res image Download (PPT)