Palabras clave
Maternal health
Early diagnosis
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Resumen
Objetivo: Destacar, revisar y analizar las evidencias involucradas en la pérdida gestacional recurrente (PGR), con el fin de contribuir a la práctica clínica. Métodos: Se realizó una revisión integrativa en las bases de datos PubMed y BVS, utilizando los descriptores “recurrent miscarriage” y “causes”, combinados con el operador booleano “AND”. Se incluyeron artículos publicados en los últimos tres años (2022–2025), así como ensayos clínicos controlados y estudios observacionales. Se excluyeron los artículos que no abordaban el embarazo espontáneo y aquellos restringidos a poblaciones específicas, resultando en un total de 34 artículos. Resultados: La pérdida gestacional recurrente abarca distintas etiologías. Más del 60% de los estudios abordaron mutaciones genéticas o anomalías relacionadas con el sistema reproductor femenino. Entre otras causas se incluyen alteraciones endocrinas, factores de estilo de vida, trastornos de la coagulación, infecciones y exposición a sustancias tóxicas. Consideraciones finales: El control prenatal es de gran importancia para identificar estos factores y prevenir la pérdida gestacional recurrente, garantizando la salud física y el bienestar emocional de la mujer.
Referencias
AHMED ZAE, et al. Role of prothrombin and methylenetetrahydrofolate reductase gene polymorphisms as well as thrombophilia markers, as risk factors for unexplained recurrent miscarriage: A case-control study. International Journal of Fertility & Sterility, 2025; 19(1): 36-43.
ATHAR A, et al. Genetic landscape of thrombophilia in recurrent miscarriages. Obstetrics & Gynecology Science, 2024; 67(5): 435-448.
BARROS BP, et al. Abortamento de repetição: etiologia e cuidados. Development, 2020; 9(11): e53891110277.
BUSNELLI A, et al. The importance of the “uterine factor” in recurrent pregnancy loss: a retrospective cohort study on women screened through 3D transvaginal ultrasound. Human Reproduction, 2024; 39(8): 1645-1655.
CHEUNG KW, et al. Clinical presentation, investigation, underlying causes, and subsequent pregnancy outcomes among different phenotypes of second trimester miscarriage. Journal of Obstetrics and Gynaecology Research, 2023; 49(2): 539-547.
CORTÉS YI, et al. Pregnancy loss is related to body mass index and prediabetes in early adulthood: Findings from Add Health. PLoS One, 2022; 17(12): e0277320.
CUADRADO-TORROGLOSA I, et al. Increased cytotoxic natural killer cells in the endometrium alone
cannot be considered the immunological cause of recurrent miscarriage. Fertility and Sterility, 2023; 120(1): 101-110.
CUENCA D. Pregnancy loss: Consequences for mental health. Frontiers in Global Women’s Health, 2022; 3: 1032212.
DANDAN LI, et al. Mediating effect of oxidative stress on association between nicotine and unexplained recurrent spontaneous abortion. Journal of Environmental and Occupational Medicine, 2022; 39(5): 512-518.
DAVALIEVA K, et al. Comparative proteomics analysis of decidua reveals altered RNA processing and impaired ribosome function in recurrent pregnancy loss. Placenta, 2024; 154: 28-37.
EL-BAZ MAH, et al. Exposure to pesticide components causes recurrent pregnancy loss by increasing placental oxidative stress and apoptosis: a case-control study. Scientific Reports, 2023; 13: 9147-9156.
EXACOUSTOS C, et al. Type and location of adenomyosis in women with recurrent pregnancy loss: A transvaginal ultrasonographic assessment. Reproductive Sciences, 2024; 31(8): 2447-2457.
EZAT SA, Haji AI. Study of association between different microRNA variants and the risk of idiopathic recurrent pregnancy loss. Archives of Gynecology and Obstetrics, 2022; 306(4): 1281-1286.
FAYEK B, et al. Uterine septum and other Müllerian anomalies in a recurrent pregnancy loss population: Impact on reproductive outcomes. Journal of Minimally Invasive Gynecology, 2023; 30(12): 961-969.
LABORDA RG, et al. Centromeric AA motif in KIR as an optimal surrogate marker for precision definition of alloimmune reproductive failure. Scientific Reports, 2024; 14(1): 3354-3363.
GONG C, et al. Low follistatin level is a causal risk factor for spontaneous abortion: a two-sample Mendelian randomization study. Frontiers in Endocrinology, 2023; 14: 1255591.
HEIDARI MM, et al. Novel nucleotide variations in the thrombomodulin (THBD) gene involved in coagulation pathways can increase the risk of recurrent pregnancy loss (RPL). Gene, 2024; 895: 148011.
HUANG X, et al. Evaluation of basal hormone levels and androgen receptor gene mutations in individuals with recurrent abortion. Cellular and Molecular Biology, 2022; 67(4): 274-281.
HVIID KVR, et al. Smoking and recurrent pregnancy loss: A cohort study of 2829 women. Journal of Reproductive Immunology, 2024; 164: 104257.
IORDACHE O, et al. A retrospective assessment of thrombophilia in pregnant women with first and second trimester Pregnancy Loss. International Journal of Environmental Research and Public Health, 2022; 19(24): 16500.
KASANO S, et al. Superfertility and subfertility in patients with recurrent pregnancy loss: A comparative analysis of clinical characteristics and etiology based on differences in fertile ability. Journal of Reproductive Immunology, 2023; 159: 104129.
KLIMASZYK K, et al. Significance of multiple myeloma oncogene 1 immunohistochemistry in chronic endometritis detection in patients with recurrent pregnancy losses: an observational study. Journal of Physiology and Pharmacology, 2023; 74(6): 1234-1245.
KROG MC, et al. Paternal HLA-derived epitopes and live birth in secondary recurrent pregnancy loss: New insights from a clinical trial. HLA, 2024; 104(4): e15723.
KUSPANOVA M, et al. Biochemical markers for prediction of the first half pregnancy losses: a review. Revista Brasileira de Ginecologia e Obstetrícia, 2024; 46(1): 201-208.
LEE JY, et al. Discovery of pathogenic variants associated with idiopathic recurrent pregnancy loss using whole-exome sequencing. International Journal of Molecular Sciences, 2024; 25(10): 5447-5458.
MIKHALEV SA, et al. Exploring the role of lower genital tract microbiota and cervical–endometrial immune metabolome in unknown genesis of recurrent pregnancy loss. International Journal of Molecular Sciences, 2025; 26(3): 1326-1359.
PEARSON-FARR JE, et al. Ultrastructural cilia defects in multi-ciliated uterine glandular epithelial cells from women with reproductive failure. Reproduction, 2024; 167(1): 345-360.
PENG L, et al. Research progress on ANXA5 in recurrent pregnancy loss. Journal of Reproductive Immunology, 2022; 153: 103679.
PEURANPÄÄ P-L, et al. The effect of paternal and maternal factors on the prognosis of live birth in couples with recurrent pregnancy loss. Acta Obstetricia et Gynecologica Scandinavica, 2022; 101(12): 1374-1385.
PRACTICE COMMITTEE OF THE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE, et al. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertility and Sterility, 2020; 113(3): 533-535.
SHAKER MM, et al. Association of MTR and MTRR polymorphisms with recurrent pregnancy loss: a case control study. Molecular Biology Reports, 2024; 51(1): 1005-1013.
SONEHARA K, et al. Common and rare genetic variants predisposing females to unexplained recurrent pregnancy loss. Nature Communications, 2024; 15(1): 5744-5753.
SOUZA MKM, et al. Caracterização de mulheres com perda gestacional recorrente acompanhadas no pré-natal de alto risco. Revista de Enfermagem e Atenção à Saúde, 2023; 13(1): 45-56.
TERSIGNI C, et al. Primary versus secondary recurrent pregnancy losses: clinical findings and live birth rate after comprehensive work-up and personalized management. Acta Obstetricia et Gynecologica Scandinavica, 2025; 104(4): 697-706.
WARTENA R, et al. Polycystic ovary syndrome and recurrent pregnancy loss, a review of literature. Frontiers in Endocrinology, 2023; 14: 1183060.
WEN Y, et al. Thrombophilic gene polymorphisms and recurrent pregnancy loss: a systematic review and meta-analysis. Journal of Assisted Reproduction and Genetics, 2023; 40(7): 1533-1558.