Chronic intervillositis of unknown etiology in patients with recurrent pregnancy loss: Impact on reproductive outcomes, treatment efficacy, and recurrence rates

Abstract

Objectives

This study aimed to examine the influence of chronic intervillositis of unknown etiology (CIUE) on reproductive outcomes in patients with recurrent pregnancy loss (RPL), determine treatment effectiveness in future pregnancies, and estimate the CIUE recurrence rate.

Materials and methods

This retrospective study examined patients with RPL, categorizing them into CIUE and non-CIUE groups. Impact of CIUE on reproductive outcomes was assessed both cross-sectionally and longitudinally. A log-rank survival analysis was conducted to assess the effectiveness of various treatments on achieving ongoing pregnancies or live births following an initial episode of CIUE. Lastly, CIUE recurrence rate was evaluated.

Results

A total of 394 patients were included in the study: 23 in the CIUE group and 371 in the non-CIUE group. No significant differences were observed between the groups regarding baseline characteristics. Adjusted logistic regression showed that patients with CIUE had higher odds of experiencing preterm birth compared to non-CIUE patients (odds ratio [OR] = 3.15; 95 % confidence interval [CI]: 1.07–9.22). With each additional pregnancy, the non-CIUE group had 75 % increased odds of achieving live birth (OR 1.75; 95 % CI: 1.49–2.06), while the CIUE group's increase was not significant (OR 1.32; 95 % CI: 0.86–2.05). Additionally, the odds of stillbirth associated with additional pregnancies increased by 85 % in the CIUE group (OR 1.85; 95 % CI: 1.03–3.36), yet not significant in the non-CIUE group (OR 1.14; 95 % CI: 0.90–1.45). CIUE-treated patients had higher odds of achieving live birth or ongoing pregnancy after 24 months (P = 0.0491). CIUE recurred in 21.7 % of patients.

Conclusion

In the RPL population, CIUE adversely affected the reproductive outcomes. Despite its high recurrence rate, prophylactic treatment showed potential in improving outcomes.