AUTHOR=Eleje George Uchenna , Ugwu Emmanuel Onyebuchi , Igbodike Emeka Philip , Malachy Divinefavour Echezona , Nwankwo Ekeuda Uchenna , Ugboaja Joseph Odirichukwu , Ikechebelu Joseph Ifeanyichukwu , Nwagha Uchenna Ifeanyi 

TITLE=Prevalence and associated factors of recurrent pregnancy loss in Nigeria according to different national and international criteria (ASRM/ESHRE vs. WHO/RCOG)

JOURNAL=Frontiers in Reproductive Health

VOLUME=Volume 5 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2023.1049711

DOI=10.3389/frph.2023.1049711

ISSN=2673-3153

ABSTRACT=Background
In low-and middle-income countries, no conclusive research explains the prevalence and associated factors of women with a history of recurrent pregnancy loss (RPL). Some authorities have recommended further scientific research on the effect of various definitions of RPL.
 Objective
To assess prevalence and associated factors of RPL among pregnant women according to different national and international criteria: the American Society for Reproductive Medicine/ European Society for Human Reproduction and Embryology (ASRM/ESHRE; two losses) and the World Health Organization/ Royal College of Obstetricians and Gynecologists (WHO/RCOG; three consecutive losses) criteria. 
Methods
This is a cross-sectional analytical study wherein, pregnant women with prior RPL were investigated. The outcome measures were prevalence and risk factors. The associations between independent variables and outcome variable were explored using bivariate and multivariable logistic regression models. The results of these analyses were reported as adjusted odds ratios (AORs) with 95% confidence intervals (95%CI). Factors associated with RPL were identified using multivariate regression models. 
Result
Of the 378 pregnant women interviewed, the prevalence of RPL was 15.34% (58/378; 95%CI=11.65%-19.84%) and 5.29% (20/378; 95%CI=3.23%-8.17) according to the ASRM and the WHO criterion respectively. Regardless of diagnostic criteria, unexplained (AOR=23.04:95%CI:11.46-36.32), advanced maternal age (AOR=3.76:95%CI:1.68-8.40), endocrine disturbances (AOR=9.76:95%CI:1.61-63.19), uterine abnormalities (AOR=13.57;95%CI:3.54-50.60), and antiphospholipid syndrome (AOR=24.59:95%CI:8.45-71.04) were positively and independently associated with RPL. Apart from advanced maternal age, no significant risk factors were seen when the ASRM/ ESHRE criterion vs WHO/RCOG criterion or primary vs secondary type of RPL were compared.
Conclusion
The prevalence of RPL was 15.34% and 5.29% according to ASRM/ESHRE and WHO/RCOG criterion respectively, with secondary type predominating. Except advanced maternal age, no significant differences with regard to risk factors were seen according to diagnostic criteria or type of RPL. Further research is needed to confirm our findings and to better characterize the magnitude of differences.