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Pregnancy Loss and Obstetric Outcomes

Associations with spontaneous abortion, recurrent pregnancy loss, and adverse perinatal risks adjusted for maternal age.

24 sources ↓Last researched 2026-10-16

State of the Field: Pregnancy Loss and Obstetric Outcomes

Associations with spontaneous abortion, recurrent pregnancy loss, and adverse perinatal risks adjusted for maternal age. Grounded synthesis across 24 primary sources and 6 graded findings within Reproductive Medicine & Human Fertility → Andrology & Male Factor Infertility.

Synopsis · Executive Overview

Pregnancy Loss and Obstetric Outcomes is a core discipline within Reproductive Medicine & Human Fertility › Male factor after 40 › Paternal Age Effect on Embryo and Offspring Health addressing associations with spontaneous abortion, recurrent pregnancy loss, and adverse perinatal risks adjusted for maternal age. Spanning published milestones from 1989 to 2026, the indexed record comprises 24 primary sources and 6 graded findings across systematic reviews, clinical cohorts, and translational studies.

Section I · Primary Literature & Evidence Synthesis

What the Peer-Reviewed Record Establishes

The primary research record in Pregnancy Loss and Obstetric Outcomes is stratified by study design so that meta-analyses and replicated randomised controlled trials (T1–T2) carry greater epistemic weight than observational cohorts (T3–T4) or preclinical laboratory work (T5). Leading graded findings establish the core empirical baseline: [T3] BackgroundAbnormal vaginal flora and bacterial vaginosis are associated with amplified risks of late miscarriage and spontaneous preterm delivery. [23] [T3] This trial is registered at ISRCTN.com, number ISRCTN14568373.FindingsBetween Feb 2, 2009, and April 12, 2013, we randomly assigned 1228 women to the placebo group (n=610) and the progesterone group (n=618). [19]

Further clinical and mechanistic stratification across the literature demonstrates: [T3] ObjectiveSystemic lupus erythematosus is associated with multiple adverse pregnancy outcomes. [21] [T3] 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. [17]

Section II · Mechanisms, Interventions & Subgroup Calibration

Comparative Evaluation of Levers & Theoretical Models

Within Reproductive Medicine & Human Fertility → Andrology & Male Factor Infertility, mechanistic and clinical evaluation in Pregnancy Loss and Obstetric Outcomes focuses on associations with spontaneous abortion, recurrent pregnancy loss, and adverse perinatal risks adjusted for maternal age. Primary publications in the current corpus span American journal of obstetrics and gynecology, American journal of perinatology, Centre Hospitalier Universitaire de Besancon, Journal of psychiatric research.

Section III · Historical Trajectory & Contested Frontiers

Evolution of the Field, Open Debates & Active Trials

Chronologically, the field evolved through key inflection points: in 1989, The prevalence and biologic significance of lupus anticoagulant and anticardiolipin antibodies in a general … (Circulating antibodies to negatively-charged phospholipids have been implicated in the genesis of adverse pregnancy outcomes); in 2020, Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in U… (233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities); in 2025, U-CaVIT Versus Standard of Care for Prevention of Atonic Postpartum Hemorrhage After Cesarean Section in Hig… (This pilot study aims to assess performance, safety and feasibility of U-CaVIT method (Uro-Catheter Vacuum Induced Tamponade), using the Rüsch® Brillant Silicone Balloon Catheter, an urological catheter, for the prevention of atonic PPH in high-risk women unde); in 2026, Diverticulitis in Pregnancy Is Associated with High Complication Rates. (However, there is little data on this topic, and no specific guidelines on how to treat pregnant patients with the disease).

Section IV · Evidentiary Gaps & Research Frontiers

Open Questions & Priorities for the Next Research Sweep

Methodological priorities and open empirical questions queued for the next research sweep across Pregnancy Loss and Obstetric Outcomes focus on resolving subgroup effect sizes, causal mechanisms, and long-term outcomes:

  • Large-scale multicentre randomised controlled trials with standardised live-birth and long-term offspring follow-up in Pregnancy Loss and Obstetric Outcomes.
  • Age- and subgroup-stratified biomarker validation across diverse human populations.

Evidence Hierarchy (Graded Claims)

  • T1Synthesis of trials
    0 (0%)
  • T2Randomised trial
    0 (0%)
  • T3Observational, large
    4 (67%)
  • T4Observational, small or case-based
    0 (0%)
  • T5Preclinical or mechanistic
    0 (0%)
  • T6Opinion, news or unverified
    2 (33%)
6 settled0 debated0 contested / frontier

Study Designs in Indexed Literature

  • Meta-analyses, Systematic Reviews & Guidelines4 (17%)
  • Randomised Controlled Trials (RCTs)8 (33%)
  • Prospective Cohorts & Clinical Registries9 (38%)
  • Primary Literature & Archive Records3 (13%)

Publication Timeline Velocity

Fig. 1 — Field Evidence Architecture & Publication Trajectory. Distribution of methodological study designs (24 indexed publications) and 6 extracted claims graded from T1 (meta-analyses and guidelines) to T6.
Primary Citations & Landmark Studies

Key Studies Anchoring This Monograph

Synthesis & Conclusions

State of the Field Conclusions

Taken together, the evidence record in Pregnancy Loss and Obstetric Outcomes (24 primary sources, 6 graded claims, highest certainty T3 — Observational, large) separates replicated high-tier findings from early-stage hypotheses. The 2 open research priorities detailed above guide the next autonomous literature and clinical trial sweep.

Key Quantitative Takeaways

  • [T3] BackgroundAbnormal vaginal flora and bacterial vaginosis are associated with amplified risks of late miscarriage and spontaneous preterm delivery.
  • [T3] This trial is registered at ISRCTN.com, number ISRCTN14568373.FindingsBetween Feb 2, 2009, and April 12, 2013, we randomly assigned 1228 women to the placebo group (n=610) and the progesterone group (n=618).
  • [T3] ObjectiveSystemic lupus erythematosus is associated with multiple adverse pregnancy outcomes.
  • [T3] 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities.
  • Open frontier in Pregnancy Loss and Obstetric Outcomes: Large-scale multicentre randomised controlled trials with standardised live-birth and long-term offspring follow-up in Pregnancy Loss and Obstetric Outcomes.
Historical timeline (4 milestones, 1989–2026)
  1. 1989

    The prevalence and biologic significance of lupus anticoagulant and anticardiolipin antibodies in a general …

    Circulating antibodies to negatively-charged phospholipids have been implicated in the genesis of adverse pregnancy outcomes.

  2. 2020

    Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in U…

    233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities.

  3. 2025

    U-CaVIT Versus Standard of Care for Prevention of Atonic Postpartum Hemorrhage After Cesarean Section in Hig…

    This pilot study aims to assess performance, safety and feasibility of U-CaVIT method (Uro-Catheter Vacuum Induced Tamponade), using the Rüsch® Brillant Silicone Balloon Catheter, an urological catheter, for the prevention of atonic PPH in high-risk women unde

  4. 2026

    Diverticulitis in Pregnancy Is Associated with High Complication Rates.

    However, there is little data on this topic, and no specific guidelines on how to treat pregnant patients with the disease.

Evidence by study design (6 findings across T1–T6)

Strongest support first. The bar beside each finding shows its grade.

Observational, large

  1. #1 BackgroundAbnormal vaginal flora and bacterial vaginosis are associated with amplified risks of late miscarriage and spontaneous preterm delivery.

    Effect of early oral clindamycin on late miscarriage and preterm del… (2003)

    Extracted from primary rct literature (2003, 212 citations).

  2. #2 This trial is registered at ISRCTN.com, number ISRCTN14568373.FindingsBetween Feb 2, 2009, and April 12, 2013, we randomly assigned 1228 women to the placebo group (n=610) and the progesterone group (n=618).

    Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM stu… (2016)

    Extracted from primary rct literature (2016, 257 citations).

  3. #3 ObjectiveSystemic lupus erythematosus is associated with multiple adverse pregnancy outcomes.

    The impact of increased lupus activity on obstetric outcomes. (2005)

    Extracted from primary cohort literature (2005, 260 citations).

  4. #4 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities.

    Characteristics and outcomes of pregnant women admitted to hospital … (2020)

    Extracted from primary cohort literature (2020, 713 citations).

Opinion, news or unverified

  1. #5 Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications.

    Reproduction at an advanced maternal age and maternal health. (2015)

    Extracted from primary expert opinion literature (2015, 221 citations).

  2. #6 Low free-beta subunit human chorionic gonadotropin levels and large nuchal translucency were both associated with early fetal loss.

    First-trimester maternal serum PAPP-A and free-beta subunit human ch… (2004)

    Extracted from primary expert opinion literature (2004, 373 citations).

Node lineage & crossover disciplines

Parent lineage, active node, direct child sub-branches, and associated crossover disciplines across the Tree of Knowledge.

Hierarchy:
Natural & Life SciencesMedicine, Health & LongevityReproductive Medicine & Human FertilityAndrology & Male Factor InfertilityPregnancy Loss and Obstetric OutcomesLeaf node (no child sub-branches yet)
+ Associated nodes:

Branches

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Primary indexed sources (24)

Primary scientific literature, systematic reviews, and clinical trial registrations indexed for this branch.

  1. Neonatal and obstetric outcomes following periconceptional exposure to glucagon-like peptide-1 receptor agonists: a systematic review and meta-analysis. — Hakim J, Rajesh D, Tello JA American journal of obstetrics and gynecology, 2026, meta analysis, 3 citations · DOI: 10.1016/j.ajog.2026.04.037
  2. Study Design of the Global Prospective Hemolytic Disease of the Fetus and Newborn Registry (GERANIUM). — Tjoa ML, Orillion A, Mankoski R et al. American journal of perinatology, 2026, registry, 1 citations · DOI: 10.1055/a-2816-3361
  3. Performance and Safety of Assisted Vaginal Delivery With the Odon Device™ Versus Vacuum Extraction Centre Hospitalier Universitaire de Besancon, 2026, rct
  4. Effects of antidepressant treatment on fetal development and obstetric complications: a retrospective ultrasound study. — Riediker A, Ochsenbein-Kölble N, Simões-Wüst AP et al. Journal of psychiatric research, 2026, cohort · DOI: 10.1016/j.jpsychires.2026.07.018
  5. Meta-analysis of Maternal and Fetal Outcomes of Crimean-Congo Hemorrhagic Fever during Pregnancy. — Donk B, Güllü D, Cırık AM et al. Emerging infectious diseases, 2026, meta analysis · DOI: 10.3201/eid3210.260383
  6. Placental lesions in systemic lupus erythematosus: A retrospective histopathological study in a tertiary care center. — Çobankent Aytekin E, Durna D, Toru HS Medicine, 2026, cohort · DOI: 10.1097/md.0000000000051023
  7. Carbetocin Monotherapy Versus Carbetocin Plus Oxytocin Infusion in Elective Cesarean Delivery: A Non-Inferiority Trial Mansoura University, 2026, rct
  8. Recombinant Human Granulocyte Colony-stimulating Factor for Reproductive Failure: A Systematic Review and Meta-analysis. — Belarmino ÉLRD, Sobral DS, Cavalcante RPD et al. JBRA assisted reproduction, 2026, meta analysis · DOI: 10.5935/1518-0557.20260046
  9. Pregnancy Outcomes of Cervical Cerclage in a Tertiary Care Centre: A Retrospective Study. — Sharma D, Verma S, Devi S Cureus, 2026, cohort · DOI: 10.7759/cureus.115728
  10. Diverticulitis in Pregnancy Is Associated with High Complication Rates. — Colpitts D, Hynes AM, Santorelli J et al. Surgical infections, 2026, guideline · DOI: 10.1177/10962964261441488
  11. U-CaVIT Versus Standard of Care for Prevention of Atonic Postpartum Hemorrhage After Cesarean Section in High-risk Women. Christian Haslinger, 2025, rct
  12. OBS-QoR-10 in Patients With and Without Postpartum Hemorrhage Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 2025, cohort
  13. Simultaneous mRNA COVID-19 and IIV Vaccination in Pregnancy Study Duke University, 2024, rct
  14. The Effects of Uterine Fibroids on Pregnancy in Women Wenwen Wang, 2023, cohort
  15. Tranexamic Acid for Reducing Blood Loss in High-Risk Cesarean Delivery Mert Yetgin, 2022, rct
  16. 30% or 60% Oxygen at Birth to Improve Neurodevelopmental Outcomes in Very Low Birthweight Infants University of Alberta, 2022, rct
  17. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. — Knight M, Bunch K, Vousden N et al. BMJ (Clinical research ed.), 2020, cohort, 713 citations · DOI: 10.1136/bmj.m2107
  18. [Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]. — Zhang L, Jiang Y, Wei M et al. Zhonghua fu chan ke za zhi, 2020, cohort, 185 citations · DOI: 10.3760/cma.j.cn112141-20200218-00111
  19. Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial. — Norman JE, Marlow N, Messow CM et al. Lancet (London, England), 2016, rct, 257 citations · DOI: 10.1016/s0140-6736(16)00350-0
  20. Reproduction at an advanced maternal age and maternal health. — Sauer MV Fertility and sterility, 2015, expert opinion, 221 citations · DOI: 10.1016/j.fertnstert.2015.03.004
  21. The impact of increased lupus activity on obstetric outcomes. — Clowse ME, Magder LS, Witter F et al. Arthritis and rheumatism, 2005, cohort, 260 citations · DOI: 10.1002/art.20864
  22. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). — Dugoff L, Hobbins JC, Malone FD et al. American journal of obstetrics and gynecology, 2004, expert opinion, 373 citations · DOI: 10.1016/j.ajog.2004.06.052
  23. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. — Ugwumadu A, Manyonda I, Reid F et al. Lancet (London, England), 2003, rct, 212 citations · DOI: 10.1016/s0140-6736(03)12823-1
  24. The prevalence and biologic significance of lupus anticoagulant and anticardiolipin antibodies in a general obstetric population. — Lockwood CJ, Romero R, Feinberg RF et al. American journal of obstetrics and gynecology, 1989, expert opinion, 183 citations · DOI: 10.1016/0002-9378(89)90522-x