Family history and risk of miscarriage: a systematic review and meta-analysis of observational studies

Andrea MF Woolner* (Corresponding Author), Priti Nagdeve, Edwin Amalraj Raja, Siladitya Bhattacharya, Sohinee Bhattacharya

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)
8 Downloads (Pure)


INTRODUCTION: Miscarriage, a spontaneous pregnancy loss at <24 weeks' gestation, is a common complication of pregnancy but the etiologies of miscarriage and recurrent miscarriage are not fully understood. Other obstetric conditions such as preeclampsia and preterm birth, which may share similar pathophysiology to miscarriage, exhibit familial patterns, suggesting inherited predisposition to these conditions. Parental genetic polymorphisms have been associated with unexplained miscarriage, suggesting there could be a genetically inherited predisposition to miscarriage. This systematic review and meta-analysis of observational studies aimed to assess the association between family history of miscarriage and the risk of miscarriage in women.

MATERIAL AND METHODS: A systematic review and meta-analysis of observational studies was carried out in accordance with Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Electronic searches using databases (MEDLINE, EMBASE and CINAHL) were carried out to identify eligible studies from 1946 until 2019. Observational studies (cohort or case-control) were included. Human studies only were included. Participants were women of reproductive age. Exposure was a family history of one or more miscarriage(s). The primary outcome was miscarriage in women. Abstracts were screened and data were extracted by two independent reviewers. Study quality was assessed using Critical Appraisal Skills Program (CASP) tools. Data were pooled from individual studies using the Mantel-Haenszel method to produce pooled odds ratios (ORs) with 95% confidence intervals (95% CI). Systematic review registration number (PROSPERO): CRD42019127950.

RESULTS: Thirteen studies were identified in the systematic review; 10 were eligible for inclusion in the meta-analysis. Twelve studies reported an association between family history of miscarriage and miscarriage in women. In all, 41 287 women were included in the meta-analysis. Women who miscarried were more likely to report a family history of miscarriage (pooled unadjusted OR 1.90, 95% CI 1.37-2.63). Overall study quality and size varied, with few adjusting for confounding factors. Results should be interpreted with caution as the associations presented are based on unadjusted analyses only.

CONCLUSIONS: Women who miscarry may be more likely to have a family history of miscarriage. Further research is required to confirm or refute the findings.

Original languageEnglish
Pages (from-to)1584-1594
Number of pages11
JournalActa Obstetricia et Gynecologica Scandinavica
Issue number12
Early online date9 Jul 2020
Publication statusPublished - Dec 2020

Bibliographical note

Funding Information:
Thanks to Mel Bickerton, Information Consultant & Site Services Manager, Medicine & Medical Sciences Library, Special Collections & Museums University of Aberdeen Medical Library, who reviewed and provided advice on the search strategy for the systematic review.

Publisher Copyright:
© 2020 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG)

Copyright 2020 Elsevier B.V., All rights reserved.


  • familial
  • family history
  • inherited
  • miscarriage
  • predisposition
  • recurrent miscarriage
  • Miscarriage


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