Fetal death repetition: The event memory hypothesis

SummaryFetal death recurrence is an important problem in reproductive health that is poorly understood. Based on preliminary epidemiologic evidence, we propose an “event memory” hypothesis which posits that when fetal death occurs the event is retained (memorized) as a program that is replayed in future pregnancies. We describe a pathway through which excessive programmed death (apoptosis) that mediates fetal demise in an initial pregnancy gets stored as an apoptotic cascade program that is replayed in a subsequent pregnancy regardless of the cause of the initial pregnancy loss. We propose an innovative method by which this hypothesis could be tested. If proven, the hypothesis will potentially represent a shift in paradigm in the field of epidemiology by introducing a new dimension (memory recall) to the cause--effect inference model; it will create a new intervention concept in prevention science, and will positively influence inter-conceptional care for mothers with a previous fetal death.