Can we really make a difference in reducing the heartbreak of millions of miscarriages each year?

ADELAIDE,Australia,Sept. 11,2023 -- Globally,one in six pregnancies end in miscarriage,which is generally defined as the loss of an intrauterine pregnancy before viability. This equates to an estimated 23 million miscarriages every year,or over 40 miscarriages per minute.

The physical effects of miscarriage – including bleeding,pain and infection – along with its psychological impacts can be profound,especially in cases of recurrent pregnancy loss. Furthermore,the cost of miscarriage for individuals and health care systems is enormous.

Arri Coomarasamy,Professor of Gynaecology and Reproductive Medicine at the University of Birmingham,leads an acclaimed team of scientists and doctors researching the causes of and treatments for miscarriage.

In a keynote presentation to the Asia Pacific Initiative on Reproduction (ASPIRE) 2023 Congress in Adelaide,Professor Coomarasamy explained new lines of research that could reduce the incidence of miscarriage.

Risk factors for miscarriage include very young or older female age (younger than 20 years and older than 35 years),older male age (older than 40 years),very low or very high body-mass index,previous miscarriages,smoking,alcohol,stress,air pollution and exposure to pesticides.

Professor Coomarasamy said the prevalence and effects of miscarriage were not fully understood by many women,and its impacts were not adequately recognised among health care providers,policy makers and funding bodies.

He emphasised the need for more effective gathering and reporting of data to facilitate comparison of miscarriage rates among countries,and the importance of accelerating research to improve patient care and policy development.

"We need to encourage and improve public and private investment in pregnancy research while developing a culture of offering participation in research to pregnant women," he said.

"In many cases,miscarriage is not inevitable. Indeed,there are a number of treatment options that can reduce the occurrence of a miscarriage,for example progesterone treatment in high-risk women,heparin in women with antiphospholipid syndrome,and thyroxine to those with underactive thyroid disease.

"However,many miscarriages remain unexplained and there is an urgent need to research the aetiology of miscarriage comprehensively.

"For example,we need to better understand the role of the lining of the womb (endometrium) on miscarriage,the effect of the community of bacteria ('microbiome') in the vagina on miscarriage risk,and the effect of man's sperm,for example sperm DNA fragmentation level,on miscarriage risk.

"These new lines of investigations are likely to help us to better understand the causes of miscarriage,and perhaps more importantly,give new therapeutic options to reduce the risk of miscarriage."

Meanwhile,Professor Coomarasamy today outlined some lifestyle factors that could help prevent miscarriage including:

having a high intake of fruits and vegetables,which is linked with a 60 per cent relative reduction in the odds of miscarriage;

women who smoke have a 17 per cent higher risk of miscarriage when compared with women who do not smoke;

women who consume alcohol have 19 per cent higher odds of miscarriage compared with those who abstain;

high intake of caffeine is also associated with an increase infoetal growth restriction and stillbirth;

sleep dysfunction such as short duration of sleep (i.e.,less than 6 hours of sleep) are very strongly linked to miscarriage. Sleep dysfunction is also linked to several other complications such as preterm births,pregnancy-related diabetes (gestational diabetes),hypertensive disorders of pregnancy and perinatal depression; and

persistent stress affects bodily hormonal (endocrine) and immune functions which,in turn,are closely linked to pregnancy outcomes.

Professor Coomarasamy is Director of the UK-based pregnancy research and support body,Tommy's National Centre for Miscarriage Research,and Joint Director of the World Health Organisation Collaborating Centre for Global Women's Health.

He said valuable information could be found through the Tommy's Miscarriage Support Tool at www.miscarriagetool.tommys.org

Global leaders in assisted reproduction have gathered for the ASPIRE 2023 Congress at the Adelaide Convention Centre. ASPIRE,which embraces more than 20 countries throughout the Asia Pacific and beyond,is dedicated to improving access to and quality of services for the one in six couples striving to achieve parenthood.

INTERVIEW:

Professor Arri Coomarasamy is available for interview at the ASPIRE Congress.

To arrange,please contact Trevor Gill,ASPIRE Media Relations

Telephone 61 418 821948 or email lighthousepr@adelaide.on.net