Women who have close relatives with endocrine disorders such as type 2 diabetes, thyroid disease and polycystic ovary syndrome (PCOS) are at higher risk of pregnancy loss, a new study has found.
The study, presented today at the ESHRE 40th Annual Meeting in Amsterdam, investigated the association between various endocrine disorders and the incidence of pregnancy loss. The study looked at 366,539 women in Denmark between 1973 and 2022.
The study found that women whose parents had been diagnosed with an endocrine disorder had a 6% higher risk of pregnancy loss compared with women with no family history of endocrine disease. Similarly, if a woman had a sister with an endocrine disorder, her risk of pregnancy loss increased by 7%. These patterns held up even when individual cases of the disease were considered.
The results highlight that a family history of endocrine disease is an important, yet previously understudied, factor in assessing the risk of pregnancy loss.
This study is the first to link familial endocrine disorders with pregnancy loss, providing evidence that these familial disorders contribute to risk.
“We believe that the mechanism linking familial endocrine disorders and miscarriage is a common genetic background that predisposes individuals to both endocrine disorders and miscarriage. One possible mechanism may involve high-risk human leukocyte antigens (HLA), which define the immune system’s ability to distinguish between ‘good and bad.’ Certain HLA types are known to be associated with several endocrine and autoimmune disorders and may also be associated with miscarriage.”
Dr Pia Egerup of Hvidovre Hospital, University of Copenhagen, lead author of the study
The endocrine system is a complex collection of glands and organs that use hormones to regulate various bodily processes, including metabolism, growth, and mood. Dysfunction in one or more parts of the endocrine system can lead to hormonal imbalances, or the body’s inappropriate response to the hormones produced. Causes of endocrine disorders vary by condition and include type 1 and type 2 diabetes, PCOS, and hyper- or hypothyroidism.
In addition to finding an association between familial endocrine disorders and miscarriage, the study also showed that there was a significant association between miscarriage and endocrine disorders, and that the association increased with the number of miscarriages. Compared with women without endocrine disorders, women with endocrine disorders had a 15% higher risk of one miscarriage (odds ratio 1.15, 95% confidence interval 1.12-1.17), a 30% higher risk of two miscarriages (odds ratio 1.30, 95% confidence interval 1.24-1.37), and a significantly higher risk of three or more miscarriages (odds ratio 1.81, 95% confidence interval 1.70-1.93).
Recurrent miscarriage affects 2-5% of women trying to conceive, and in around half of these cases the cause remains unknown. Recurrent miscarriage can be psychologically and emotionally taxing, with around 10% of affected couples experiencing moderate or severe symptoms of depression, along with feelings of anxiety, sadness, guilt and anger.
“Understanding the common mechanisms between miscarriage and endocrine disorders may lead to new preventive and therapeutic strategies to prevent miscarriage,” Dr. Egerup added. “Furthermore, these findings encourage health care professionals to take family history into account when diagnosing and treating women with recurrent miscarriage.”
“This study provides evidence that the risk of pregnancy loss increases if a woman has certain endocrine disorders in her family. This information highlights the importance of collecting a detailed family history of all pregnant women in order to take potential preventive measures,” commented Professor Carlos Caljas-Jorge, immediate past president of ESHRE.
An abstract of the study will be published today in Human Reproduction, one of the world’s leading reproductive medicine journals.
sauce:
European Society for Human Reproduction and Embryology
