Incidence and causes of pregnancy loss after day 70 of gestation in Thoroughbreds.

Abstract

BACKGROUND Pregnancy loss after day 70 of gestation manifests as abortion, stillbirth or perinatal death. While previous studies have reported the diagnoses of laboratory submissions, none have quantified the incidence and causes of abortions, stillbirths and perinatal mortality at a population level. OBJECTIVES To report the incidence and causes of pregnancy loss after day 70 of gestation in a cohort of Thoroughbreds. STUDY DESIGN Retrospective cohort study. METHODS Outcomes of day 70 pregnancies were collected from eight Thoroughbred farms over the 2013-2017 breeding seasons. Stud, veterinary and laboratory records were supplemented with publicly available data. Cause of loss was categorised using custom criteria. RESULTS Data were collected on 3,586 pregnancies from 1,802 mares. The incidence risk of a pregnancy failing to produce a live foal at 24 hours post parturition was 7.3% (95% confidence interval (CI) 6.5-8.2, equating to 7.3 cases per 100 day-70 pregnancies). The incidence of pregnancy loss between day 70 and 300 of gestation, day 301 to 315 and stillbirth/perinatal death was 4.0% (95% CI 3.4-4.7), 0.3% (95% CI 0.2-0.6) and 1.4% (95% CI 1.1-1.9), respectively. Of the pregnancy losses where tissue was available, 61.1% were submitted for post mortem examination. The incidence risk of loss due to umbilical cord-related pathologies was 1.5% (95% CI 1.1-1.9), 0.4% (95% CI 0.2-0.6) for non-infectious placental disease and 0.3% (95% CI 0.2-0.6) for both infectious placentitis and Equine Herpesvirus infection. No primary diagnosis was made in 11.2% of the cases which underwent full post mortem examination. Main limitations: It was not possible to differentiate between intra-partum stillbirth and early post-partum death. CONCLUSION Pregnancy loss after day 70 of gestation is a significant source of loss in the Thoroughbred with umbilical cord-related pathologies being the most commonly diagnosed cause. Reporting the incidence of pregnancy loss at a population level with clear case definitions will allow for accurate global comparisons.