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Two main risk factors increase the likelihood for the development of GTD: 1) The woman being under 20 years of age, or over 35 years of age, and 2) previous GTD. [8] [9] [10] Although molar pregnancies affect women of all ages, women under 16 and over 45 years of age have an increased risk of developing a molar pregnancy. [11]
Gestational choriocarcinoma can happen during and after any type of pregnancy event, though risk of the disease is higher in and after complete or partial molar pregnancies. [3] Risk of disease may also be higher in those experiencing pregnancy at younger or older ages that average, such as below 15 years old or above 45 years old. [4]
The cause of this condition is not completely understood. Potential risk factors may include defects in the egg, abnormalities within the uterus, or nutritional deficiencies. Women under 20 or over 40 years of age have a higher risk. Other risk factors include diets low in protein, folic acid, and carotene. [7]
GTN often arises after molar pregnancies but can also occur after any gestation including miscarriages and term pregnancies. [6] Although risk factors may impact on the development of the tumor, most do not directly cause of disease. According to some studies, the risk of complete molar pregnancy is highest in women over age 35 and younger than 20.
“Gravidity” is an important component of a patient’s reproductive history, as it provides insight into the risk factors that the patient has for pregnancy outcomes, such as risk for gestational diabetes, pre-ecclampsia, spontaneous abortion, preterm birth, fetal growth restriction, and more. [5]
These patient factors include: (1) size of cyst and whether or not it is benign or malignant, (2) patient symptoms, (3) patient age, and (4) impact of cyst on the pregnancy. [23] Benign cysts less than 6 cm are more likely to spontaneously resolve over time. Surgical treatments may be needed for serious complications due to theca lutein cysts.
An important risk factor for placenta accreta is placenta previa in the presence of a uterine scar. Placenta previa is an independent risk factor for placenta accreta. Additional reported risk factors for placenta accreta include maternal age and multiparity, other prior uterine surgery, prior uterine curettage, uterine irradiation, endometrial ablation, Asherman syndrome, uterine leiomyomata ...
Risk rises with age: around 14% for women aged 30–34; 18% for those 35–39; 37% for those 40–44; and 65% for those over 45. [68] Women younger than 20 have slightly increased miscarriage risk, with around 16% of known pregnancies ending in miscarriage. [68]
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