Maternal recurrent pregnancy loss is associated with an increased risk for long-term neurological morbidity in offspring

Aim: To determine whether maternal history of recurrent pregnancy loss (RPL) impacts on the long-term neurological health of the offspring. Method: A population-based cohort analysis was performed, including all singletons born between 1991 and 2014 at a single regional tertiary centre. Neurological morbidity up to age 18 years (including cognitive, motor, and psychiatric disorders) in children born to mothers with and without a history of RPL was compared. Cumulative neurological morbidity incidence was compared with survival curves and a Weibull multivariable survival model to control for follow-up time and relevant confounders. Results: A total of 242 187 deliveries met the inclusion criteria during the study period, 5% (n=12 182) of which were in mothers with RPL. Epilepsy and developmental disorders were significantly more common in the group with RPL (0.95 vs 0.74/1000 person-years [p=0.009] and 0.22 vs 0.09/1000 person-years [p<0.001]). The survival curves demonstrated significantly higher cumulative incidences of epilepsy and developmental disorders in the group with RPL. The multivariable model exhibited an independent association between maternal RPL and childhood epilepsy (adjusted hazard ratio 1.23; 95% confidence interval 1.01–1.50) and developmental disorders in the offspring (adjusted hazard ratio 2.41; 95% confidence interval 1.60–3.64). Interpretation: A history of maternal RPL appears to be independently associated with long-term neurological morbidity of the offspring. What this paper adds: Hospitalizations for epilepsy and developmental disorders are significantly more common among children of mothers with a history of recurrent pregnancy loss.