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September 19, 1990

Autoimmunity and Pregnancy Loss

JAMA. 1990;264(11):1453-1454. doi:10.1001/jama.1990.03450110099036

The spontaneous loss of a clinically recognized pregnancy is the most common complication of human gestation and is a significant emotional disappointment for the involved couple. Recurrent pregnancy loss (traditionally defined as three consecutive losses) occurs in 0.5% to 1% of women, an incidence equal to or exceeding that of most major medical problems. Genetic, anatomic, hormonal, and infectious factors have each been implicated as causing some spontaneous abortion, but even when taken together they do not explain the majority of losses. Within the last 10 years several maternal autoimmune conditions have been linked to pregnancy loss. Although these autoimmune conditions do not appear to explain a large proportion of losses, they are as important numerically as uterine malformations and parental chromosome abnormalities.

A few maternal autoimmune conditions cause pregnancy loss through the transplacental passage of maternal autoantibodies that act on the fetus through classic autoantibody-mediated mechanisms. The best example