Christiansen O B, Pedersen B, Nielsen H S, Nybo Andersen A-M
Fertility Clinic 4071, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Hum Reprod. 2004 Dec;19(12):2946-51. doi: 10.1093/humrep/deh516. Epub 2004 Oct 28.
The carriage of a male fetus often initiates maternal immunological reactions against male-specific minor histocompatibility (HY) antigens, which, in theory, could result in subsequent recurrent miscarriage (RM).
Information about subsequent pregnancy outcome was procured among 182 women with RM after a birth (secondary RM) referred since 1986 using questionnaires, telephone interviews and registers.
Significantly more of the women had had a male first-born as compared with a female first-born (110 versus 72; P < 0.02). By January 2002, 58% of those who had a male first-born had given birth to a second live infant compared with 76% of those who previously had had a female first-born (P = 0.01). Women in the former group had a significantly lower chance of having a second child than those in the latter (adjusted hazard ratio 0.59; 95% confidence interval 0.41-0.86). The number of miscarriages after admission and the risk of secondary infertility were significantly greater in women with a male first-born than among those with a female first-born (P < 0.001 and P = 0.02; respectively).
A male first-born seems to be associated with a less favourable reproductive potential among women with secondary RM. Maternal immunization against HY antigens may be responsible for these findings.
怀有男胎往往会引发母体针对男性特异性次要组织相容性（HY）抗原的免疫反应，理论上，这可能导致随后的复发性流产（RM）。
自1986年起，通过问卷调查、电话访谈和登记册，收集了182例产后复发性流产（继发性RM）妇女的后续妊娠结局信息。
与头胎为女性的妇女相比，头胎为男性的妇女明显更多（110例对72例；P<0.02）。到2002年1月，头胎为男性的妇女中有58%生育了第二个活婴，而头胎为女性的妇女中这一比例为76%（P=0.01）。前一组妇女生育第二个孩子的机会明显低于后一组（调整后的风险比为0.59；95%置信区间为0.41 - 0.86）。头胎为男性的妇女入院后的流产次数和继发性不孕的风险明显高于头胎为女性的妇女（分别为P<0.001和P=0.02）。
头胎为男性似乎与继发性RM妇女的生殖潜力较差有关。母体针对HY抗原的免疫反应可能是这些结果的原因。
