{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:02:03Z","timestamp":1793826123464,"version":"4.6.1"},"reference-count":21,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000306","name":"Tommy's Baby Charity","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100000306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,12,16]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To measure pregnancy outcome following attendance at a recurrent miscarriage service and identify factors that influence outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, observational electronic cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants attending a specialist recurrent miscarriage clinic, with a history of two or more pregnancy losses. 857 new patients attended over a 30-month period and were invited to participate. Participant data were recorded on a bespoke study database, \u2018Tommy\u2019s Net\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>777 women consented to participate (90.7% of new patients). 639 (82%) women continued within the cohort, and 138 were lost to follow-up. Mean age of active participants was 34 years for women and 37 years for partners, with a mean of 3.5 (1\u201319) previous pregnancy losses. Rates of obesity (maternal: 23.8%, paternal: 22.4%), smoking (maternal:7.4%, paternal: 19.4%) and alcohol consumption (maternal: 50%, paternal: 79.2%) were high and 55% of participants were not taking folic acid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Biannual collection of pregnancy outcomes, either through prompted self-reporting, or existing hospital systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>639 (82%) women were followed up. 404 (83.4%) reported conception and 106 (16.6%) reported no pregnancy, at least 6 months following registration. Of those that conceived, 72.8% (294\/404) had a viable pregnancy. Maternal smoking and body mass index (BMI) over 30 were significantly higher in those who did not conceive (p=0.001)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tommy\u2019s Net provides a secure electronic repository on data for couples with recurrent pregnancy loss and associated outcomes. The study identified that subfertility, as well as repeated miscarriage, maternal BMI and smoking status, contributed to failure to achieve live birth. Study findings may enable comparison of clinic outcomes and inform the development of a personalised holistic care package.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-052661","type":"journal-article","created":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T10:32:46Z","timestamp":1643797966000},"page":"e052661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Quantitative assessment of pregnancy outcome following recurrent miscarriage clinic care: a prospective cohort study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7442-5242","authenticated-orcid":false,"given":"Rebecca","family":"Shields","sequence":"first","affiliation":[{"name":"Division of Reproductive Health, University of Warwick, Coventry, UK"},{"name":"Tommy's National Centre for Miscarriage Research, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Khan","sequence":"additional","affiliation":[{"name":"Institute of Digital Healthcare, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lim Choi Keung","sequence":"additional","affiliation":[{"name":"Institute of Digital Healthcare, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia Jane","family":"Hawkes","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, University of Warwick, Coventry, UK"},{"name":"Tommy's National Centre for Miscarriage Research, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling","family":"Barry","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J","family":"Devall","sequence":"additional","affiliation":[{"name":"Tommy\u2019s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D","family":"Quinn","sequence":"additional","affiliation":[{"name":"5. Tommy\u2019s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D","family":"Keay","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-135X","authenticated-orcid":false,"given":"Theodoros N","family":"Arvanitis","sequence":"additional","affiliation":[{"name":"Institute of Digital Healthcare, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8557-7276","authenticated-orcid":false,"given":"Debra","family":"Bick","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Quenby","sequence":"additional","affiliation":[{"name":"Tommy's National Centre for Miscarriage Research, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"},{"name":"Institute of Early Life, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,2]]},"reference":[{"key":"2025120618415274000_12.2.e052661.1","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1016\/S0140-6736(21)00682-6","article-title":"Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss","volume":"397","author":"Quenby","year":"2021","journal-title":"Lancet"},{"key":"2025120618415274000_12.2.e052661.2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e31802f1c28"},{"key":"2025120618415274000_12.2.e052661.3","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.11.2868"},{"key":"2025120618415274000_12.2.e052661.4","unstructured":"ESHRE Early Pregnancy Guideline Development Group (GDG) . Recurrent pregnancy loss, European Society of reproduction and embryology, 2017."},{"key":"2025120618415274000_12.2.e052661.5","unstructured":"Regan L , Backos M , Rai R . Recurrent miscarriage, investigations and treatment of couples. 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