Abstract
Objective:
This study was performed to determine whether second-trimester pregnancy loss was associated with an increased risk for spontaneous preterm birth or recurrent second-trimester loss in a subsequent pregnancy.

Study Design:
A retrospective cohort study was conducted. Patients with a second-trimester pregnancy loss (n=38), a spontaneous preterm birth (n=76), and a full term delivery (n=76) were identified from 2002 to 2005 (index pregnancy). Computerized medical records were used to obtain demographic and obstetrical histories.

Results:
Frequencies of subsequent second-trimester loss were 27%, 3%, and 1% in the second-trimester loss, spontaneous preterm birth, and full-term delivery cohorts, respectively. Frequencies of subsequent spontaneous preterm birth were 33%, 39.5%, and 9% in the same 3 cohorts. Patients with a prior second-trimester loss were 10.8 times more likely to have recurrent second-trimester loss or spontaneous preterm birth, compared with those with prior full-term delivery (confidence interval 3.6 to 32.1, P<.0001).

Conclusion:
Patients with a prior second-trimester loss are at significantly increased risk for spontaneous preterm birth and recurrent second-trimester loss in their next pregnancy (Fig).

Figure: Subsequent pregnancy outcome by index pregnancy cohort. 2nd Trim Preg Loss, second trimester pregnancy loss; Spontaneous PTB, spontaneous preterm birth. (Reprinted from Edlow AG, Srinivas SK, Elovitz MA. Second-trimester loss and subsequent pregnancy outcomes: What is the real risk? Am J Obstet Gynecol. 2007;197:581.e1-581.e6, with permission from Elsevier.)