Miscarriage is the term health care providers use
to describe the loss of pregnancy from natural
causes before the 20th week of pregnancy. Most
miscarriages occur very early in pregnancy, in
some cases before a woman even knows she is
pregnant. Researchers estimate that, among women
who already know they are pregnant, nearly 15
percent will have a miscarriage.

There are many different causes for miscarriage,
some of them known and others unknown. In most
cases, there is nothing a woman can do to prevent
a miscarriage. Having a miscarriage does not mean
that a woman won\'t become pregnant again, or that
she will not have normal pregnancies in the
future. And, for most women, miscarriage is not a
sign of a larger health problem.

Having a miscarriage can be devastating to a woman
and her family. A woman or family who is having
trouble coping with the loss of a miscarriage
should ask a health care provider.

NICHD Research on Miscarriage

The NICHD supports and conducts research on the
causes of miscarriage in hopes of finding ways to
prevent women from having them. For instance,
NICHD-supported researchers recently found that
women with a disorder called Polycystic Ovary
Syndrome (PCOS) are three times more likely to
miscarry during the early months of pregnancy than
women who don\'t have PCOS. Women with PCOS often
have great difficulty getting pregnant naturally.

Research has found that women with PCOS also tend
to have a condition called insulin resistance,
which means their bodies have trouble using the
insulin they make to get energy from their cells.
Insulin resistance often occurs before someone
develops diabetes. To treat this insulin
resistance, researchers had been prescribing a
drug called metaformin. What they found was that
metaformin not only reduced insulin resistance,
but it also brought about changes to the uterine
lining that could help women with PCOS get
pregnant and reduce the risk of miscarriage during
their first trimester (the first three months) of
pregnancy.

Studies are now underway to confirm the positive
effects of the using metaformin in women with
PCOS, and to evaluate the safety of taking the
drug throughout pregnancy. The NICHD\'s
Reproductive Sciences Branch, through its
Reproductive Medicine Network (RMN) is currently
conducting a clinical trial for the treatment of
infertility related to PCOS, using metaformin. The
RMN Web site provides more information on this
trial and on the RNM itself.

Other NICHD-supported research is trying to learn
more about repeated miscarriage. Researchers
estimate that between 1 percent and 2 percent of
women in the United States has more than one
miscarriage without a known cause. Women who
experience repeated miscarriages may undergo
expensive and lengthy tests to try to identify a
cause, but often get no answers. NICHD
researchers, examining the genes of these women,
have found that many of them share a genetic
mutation, or change. This mutation, on one of the
X chromosomes, was found in nearly 15 percent of
women who had a history of repeated, unexplained
miscarriage. If this genetic mutation is confirmed
as a cause of repeated miscarriages, researchers
may be able to develop a simple blood test that
could predict a woman\'s chances of having a
miscarriage in future pregnancies.

For more information on NICHD-supported research
on miscarriage, read the Institute\'s news
releases on miscarriage. The National Library of
Medicine provides additional information on
pregnancy loss, which includes miscarriage. For
more information, visit the Medem™ Website and do
a search for \"recurrent miscarriage\" in the
medical library.

Stillbirth

Stillbirth is the term health care providers use
to describe the loss of a pregnancy after the 20th
week of pregnancy, due to natural causes.
According to national statistics, stillbirths
occur in nearly one in 200 pregnancies in the
United States every year.

Stillbirth can occur before delivery, or as a
result of complications during labor and delivery.
In at least half of all cases, researchers can
find no cause for the pregnancy loss.

In some cases of stillbirth, the mother may notice
a decrease in the movement or kicking of the
fetus. In these cases, the health care provider
uses an ultrasound, a machine that uses sound
waves to create a picture of the fetus, to learn
more about its health. If you are pregnant and
have concerns about stillbirth, ask your health
care provider if there are special ways he or she
wants you to track movement.

Stillbirth can be devastating to a woman and her
family. If you or your family are having trouble
coping with the loss of a stillbirth, please talk
to your health care provider.

In spite of how often stillbirth occurs, and how
emotionally painful it can be, little research has
been done on this type of pregnancy loss. To
encourage more research on stillbirth, the NICHD
is supporting a new research initiative, Research
on the Scope and Causes of Stillbirth in the
United States. Through this effort, the NICHD will
create a network of research sites whose sole
focus will be on understanding stillbirth, its
features, its causes, and its effects on a
woman\'s uterus. Patients in this network will
include women from a variety of ethnic and
economic backgrounds, to provide a clearer picture
of this problem. Through this initiative, the
NICHD hopes to support work that may some day be
able to predict and prevent stillbirths.

The March of Dimes Birth Defects Foundation offers
some patient information about stillbirth.

Source: National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services.