First study of its kind reveals what the public and health professionals want future miscarriage research to focus on.
More research is needed to improve psychological and emotional support for women and their partners affected by miscarriage, reveals a survey published in BMJ Open and presented at the Association of Early Pregnancy Unit’s (AEPU) annual conference today (Friday).
Other top priorities include research into preventative treatment, relevance of pre-existing medical conditions, importance of lifestyle factors and genetic and chromosomal causes, investigation after different numbers of miscarriage and male causal factors.
While it is reassuring that many ongoing studies are closely aligned with these priorities, psychological and emotional support are among the less well researched areas, say the team of doctors who carried out the survey.
Miscarriage is defined as pregnancy loss from conception to 24 weeks’ gestation. More than 15% of all pregnancies end this way, but the underlying cause for the majority of miscarriages remain unexplained and there are gaps in the understanding of the psychological impacts.
Therefore, the team of UK based researchers set out to determine what questions women, their partners and health professionals want answered and prioritised in future research.
The study involved 1,093 participants, including 932 women who have experienced miscarriage, 8 partners, 17 family members, friends or colleagues, 104 healthcare professionals and eight charitable organisations, including Miscarriage Association, Tommy’s and the Royal College of Obstetricians and Gynaecologists.
Of the initial 2,402 questions, the 25 top questions were discussed in a face-to-face workshop to identify the top 10 priorities for future research.
The top research priorities identified are:
- What are the effective interventions to prevent miscarriage?
- What are the emotional and mental health impacts of miscarriage in the short term and long term for the mother and partner?
- What investigations are of true clinical value?
- To what extent do pre-existing medical conditions cause miscarriage?
- What types of emotional support are effective in preventing or treating women or their partners after a miscarriage?
- Do lifestyle factors cause miscarriage?
- To what extent do genetic and chromosomal abnormalities in the foetus cause miscarriage?
- What preconception tests or interventions prevent miscarriage?
- What are the appropriate investigations for women after one, two or three or more miscarriages?
- What male factors contribute towards the cause of miscarriage?
Dr Matthew Prior, lead author of the study and fertility doctor based in Newcastle, said:
"These results should be the focus of future miscarriage research. Presently, studies are being conducted to address the top priority of preventative treatment. However, many other priorities, especially psychological and emotional support, are less well researched areas. We hope our results will encourage both researchers and funders to focus on these priorities to drive improvements in the prevention of miscarriage and in the care of those affected."
Professor Lesley Regan, co-author of the study and President of the Royal College of Obstetricians and Gynaecologists, said:
“Miscarriage can have a devastating impact on women, their partners and families. However, it remains a largely under-researched and taboo subject despite how common it is. This silence contributes to the idea that it is ‘not a problem’ and prevents investment in the research and development needed to understand the causes of and consequent prevention of miscarriage, as well as improved emotional and physiological support for those affected."
Jane Brewin, Chief Executive Officer of Tommy’s said:
“Defining the top 10 priorities for miscarriage research is a positive step forward for parents; it raises the profile of miscarriage which is the biggest cause of pregnancy loss in the UK and places an unacceptable burden of distress on parents’ lives. We now hope that more funders will join with Tommy’s to fund research to prevent miscarriage and provide better care for parents who experience this. It’s time to accelerate our understanding and offer tests that tell parents what the cause of their miscarriage was so that we can move towards treatments. We are determined that this work will be a catalyst for change.”
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Priorities for research in miscarriage: a priority setting partnership between people affected by miscarriage and professionals following the James Lind Alliance methodology. BMJ Open. http://bmjopen.bmj.com/content/7/8/e016571
About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.