Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3940200 | Fertility and Sterility | 2008 | 5 Pages |
ObjectiveTo test our previously generated hypothesis that women with secondary recurrent miscarriages with a firstborn boy have a poorer pregnancy prognosis than those with a firstborn girl.DesignA study of a retrospective and a prospective cohort.SettingThe Danish recurrent miscarriage clinic.Patient(s)Two cohorts of 175 and 130 consecutive patients with unexplained secondary recurrent miscarriage referred from 1986 to 1999 (cohort 1) and 2000 to 2005 (cohort 2), respectively.Main Outcome Measure(s)The odds ratio (OR) for a live birth in the first pregnancy after referral in those with a firstborn boy compared with a firstborn girl in each of the two cohorts. The corresponding OR for a live birth adjusted for relevant prognostic variables in the combined group of patients.Result(s)The crude ORs for a live birth in those with a firstborn boy compared with a firstborn girl were very similar in cohorts 1 and 2 (OR = 0.35, 0.33). In the adjusted analysis only two of five included variables significantly predicted live birth: a firstborn boy and the number of previous miscarriages.Conclusion(s)Male sex of the firstborn child is a strong negative prognostic factor in women with secondary recurrent miscarriage. A possible explanation is an abnormal maternal immune response against male-specific minor histocompatibility (HY) antigens.