{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:13:43Z","timestamp":1792462423821,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000770","name":"University of Manchester","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000770","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Women with a prior stillbirth or a history of recurrent first trimester miscarriages are at increased risk of adverse pregnancy outcomes. However, little is known about the impact of a second trimester pregnancy loss on subsequent pregnancy outcome. This review investigated if second trimester miscarriage or termination for medical reason or fetal anomaly (TFMR\/TOPFA) is associated with future adverse pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A systematic review of observational studies was conducted. Eligible studies included women with a history of a second trimester miscarriage or termination for medical reasons and their pregnancy outcomes in the subsequent pregnancy. Where comparative studies were identified, studies which compared subsequent pregnancy outcomes for women with and without a history of second trimester loss or TFMR\/TOPFA were included. The primary outcome was livebirth, and secondary outcomes included: miscarriage (first and second trimester), termination of pregnancy, fetal growth restriction, cesarean section, preterm birth, pre\u2010eclampsia, antepartum hemorrhage, stillbirth and neonatal death. Studies were excluded if exposure was nonmedical termination or if related to twins or higher multiple pregnancies. Electronic searches were conducted using the online databases (MEDLINE, Embase, PubMed and The Cochrane Library) and searches were last updated on June 16, 2023. Risk of bias was assessed using the Newcastle\u2010Ottawa scale. Where possible, meta\u2010analysis was undertaken. PROSPERO registration: CRD42023375033.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies were included, reporting on 12\u2009004 subsequent pregnancies after a second trimester pregnancy miscarriage. No studies were found on outcomes after second trimester TFMR\/TOPFA. Overall, available data were of \u201cvery low quality\u201d using GRADE assessment. Meta\u2010analysis of cohort studies generated estimated outcome frequencies for women with a previous second trimester loss as follows: live birth 81% (95% CI: 64\u201394), miscarriage 15% (95% CI: 4\u201330, preterm birth 13% [95% CI: 6\u201323]).The pooled odds ratio for preterm birth in subsequent pregnancy after second trimester loss in case\u2013control studies was OR 4.52 (95% CI: 3.03\u20136.74).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Very low certainty evidence suggests there may be an increased risk of preterm birth in a subsequent pregnancy after a late miscarriage. However, evidence is limited. Larger, higher quality cohort studies are needed to investigate this potential association.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14731","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T07:09:31Z","timestamp":1701414571000},"page":"413-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Subsequent pregnancy outcomes after second trimester miscarriage or termination for medical\/fetal reason: A systematic review and meta\u2010analysis of observational studies"],"prefix":"10.1111","volume":"103","author":[{"given":"Keya","family":"Patel","sequence":"first","affiliation":[{"name":"Maternal and Fetal Health Research Center, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"},{"name":"Department of Obstetrics Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6785-4371","authenticated-orcid":false,"given":"Danielle","family":"Pirie","sequence":"additional","affiliation":[{"name":"Aberdeen Center for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences &amp; Nutrition University of Aberdeen  Aberdeen UK"},{"name":"NHS Grampian, Aberdeen Maternity Hospital  Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4303-7845","authenticated-orcid":false,"given":"Alexander E. 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