Abstract

The SCOPE study recruited 5575 healthy women having their first baby and followed the course of their pregnancy, labour and birth along with outcomes for mothers and babies. Most women in the study had no previous pregnancy loss, but some had had one or more previous early pregnancy losses. This study compared outcomes in the study pregnancy between the women who had a previous pregnancy loss (which included a miscarriage or a termination of pregnancy) and those who had not, and focused on the risk of preterm birth in both groups. Women with 2-4 previous pregnancy losses, but not those with a single loss, had an increased risk of spontaneous preterm birth (having a baby before 37 weeks of pregnancy) compared with those with no previous pregnancy. A single previous miscarriage or termination of pregnancy, where the management involved was surgical, was associated with an increased risk of spontaneous preterm birth compared with those with no previous pregnancy losses, and also was higher than those who had medical management of pregnancy loss. These findings have implications for clinical decision making in early pregnancy and whether non-surgical management of miscarriage or termination of pregnancy should be advocated over surgical treatment.