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Black women face greater risk of miscarriage, research suggests.

 

Black women face a significantly higher risk of having a miscarriage than their white counterparts, research suggests.

Medical journal, The Lancet, analysed data about 4.6m pregnancies in seven countries, which, it says, suggests the risk for black women is 43% higher than for white women.

Currently, women are usually referred to specialist clinics only after three consecutive miscarriages but now The Lancet is calling for them to be given support after their first pregnancy loss.

Most countries, including the UK, do not collect statistics but the researchers estimate that 15% of pregnancies end in loss and that 1% of women will experience recurrent miscarriages.

Some estimates of miscarriage rates are higher, but this is due to differences in how countries define pregnancy loss, which can be from a positive pregnancy test or from a scan.

The report also found that women from all ethnic backgrounds, who suffer a miscarriage, are more vulnerable to long-term health problems, such as blood clots, heart disease and depression.

Doreen Thompson-Addo, who suffered seven miscarriages, said:  "You hear about how common miscarriage is but you never think it's going to happen to you."

Ms Thompson-Addo, who had her daughter Arielle in 2017, was simply told to "try again" after her first miscarriage.

After her third miscarriage, she was referred to an NHS recurrent-miscarriage clinic but never found out why she had lost multiple pregnancies.

Factors that increase the risk of miscarriage are: being aged under 20 or over 40; a previous miscarriage; being very underweight or overweight; long hours and night shifts; being black; smoking and high alcohol intake.

The research published in The Lancet suggests that help could be provided with measures including pre-conception support so women are in good condition for pregnancy; regular early scans and support from the pregnancy’s start; pelvic ultrasounds to check on the womb structure; hormone treatment; aspirin and heparin injections to reduce blood clot risks; progesterone for bleeding in early pregnancy and tests and treatment for a weak cervix.

Most of the research was carried out in Sweden, Finland and Denmark, some of the few countries that gather statistics, together with data from the US, UK, Canada and Norway.

Tommy's National Centre for Miscarriage Research deputy director, prof Siobhan Quenby, from the University of Warwick, who worked on the study, said: "We know there's an increased risk of dying in pregnancy for black women but I was very shocked to also find an increased risk of miscarriage."

Black people are at higher risk of developing type 2 diabetes and heart disease, and both conditions can increase the risk of miscarriage.

But prof Quenby said scientists were also investigating whether other health issues, such as fibroid conditions and autoimmune disorders, could help explain the higher rate. Further research was urgently needed.

About 75% of women who miscarry will go on to have a healthy pregnancy, which is partly why couples are usually encouraged to try for another baby without further investigations.

However, Prof Quenby, who also runs a recurrent-miscarriage clinic, said: "There are things we can do to prevent miscarriage. It's not a condition that's hopeless."

Lifestyle changes could help as about 30% of people referred to her clinic smoked, had uncontrolled diabetes, a high body-mass index or blood pressure.

She said: "That means the health services missed three opportunities to get them into a better state for their next pregnancy."

She added that a "graded response" is needed to provide targeted advice after one miscarriage; additional tests after two and further investigations after three.

In an editorial accompanying the research, The Lancet said: "For too long, miscarriage has been minimised and often dismissed. The lack of medical progress should be shocking. Instead, there is a pervasive acceptance. The era of telling women to 'just try again' is over."

The research also suggested there is significantly increased risks of suicide, depression and anxiety for those who miscarry and that the impact on partners needs further investigation.