Better understanding of miscarriage

Innovative research at Warwick Medical School is helping to develop a better understanding of the causes of recurrent miscarriage.  Around one per cent of all women experience recurrent miscarriage, which doctors define as the loss of three or more consecutive pregnancies.

Dr Emma Lucas is part of a team researching the womb and understanding how endometrial cells affect the chances of a woman becoming pregnant and suffering from miscarriages. Women of child-bearing age are encouraged to take dietary supplements, including folic acid and other B vitamins, in the months preceding conception of a planned pregnancy and up to at least 12 weeks gestation.

These vitamins are essential for the function of a complex metabolic cycle, known as one carbon metabolism, which has essential roles in DNA replication, cell proliferation, stem cell potential and the establishment of epigenetic modifications: a mechanism which controls gene expression levels within cells by altering the packaging of DNA.

However, small changes (known as single nucleotide polymorphisms, or SNPs) in genes which contribute to one carbon (1-C) metabolism have been associated with recurrent miscarriages, suggesting that appropriate regulation of these genes has an essential role in the establishment of a successful pregnancy.

The cause of miscarriage, especially in repeat pregnancy loss, therefore appears to lie in the preparation of the womb before pregnancy. Dr Lucas's work aims to develop tests to predict the likelihood of problems in a pregnancy before a woman becomes pregnant, and treatments to help those affected.