Program

Nurse-Midwifery M.S.

Number of Pages

41

Year Approved

2026

First Advisor

Paige Hardy

Second Reader

Rebecca D'Addosio Smith

Abstract

This integrative review explores interventions that may improve live birth rates or pregnancy outcomes for individuals experiencing recurrent pregnancy loss (RPL). Approximately 5% of couples experience RPL, and limited evidence contributes to inconsistent clinical recommendations for this population. A literature search was conducted using CINAHL, PubMed, and Nursing and Allied Health Collection. Inclusion criteria consisted of primary research studies published in English from 2016 to 2026 that evaluated preventative interventions aimed at improving live birth rates or pregnancy outcomes in individuals with RPL. Exclusion criteria included infertility unrelated to RPL, single miscarriage, animal subjects, in vitro fertilization-related studies, or studies with unclear interventions. A total of 435 studies were imported into Covidence for screening, and 36 were removed due to duplication. Twenty articles were carefully selected to be included in the review after screening, and one additional study was located through citation searching. Levothyroxine demonstrated significantly improved live birth rates in patients with subclinical hypothyroidism and recurrent pregnancy loss. Low-dose aspirin showed potential benefit in protein S deficiency and factor XII deficiency but was not beneficial in unexplained recurrent pregnancy loss. Heparin, vitamin D, lymphocyte immunotherapy, intravenous immunoglobulin, and recombinant human granulocyte colony-stimulating factor show potential benefit in unexplained pregnancy loss, though further research is needed. In antiphospholipid syndrome populations, aspirin combined with heparin is supported for clinical use. Emerging therapies such as tumor necrosis factor inhibitors and tacrolimus may benefit those with immune disorders, though further research is essential. Progesterone was shown to be beneficial, but only in those with elevated nCyclinE expression. Recurrent pregnancy loss is a multifactorial condition, and identifying the underlying cause can help pinpoint the best recommendations for each patient. No single intervention is universally effective in treating RPL; management should be individualized and etiology-specific.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

Terms of Use and License Information

Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

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