Coulam C B
Center for Reproduction and Transplantation Immunology, Methodist Hospital of Indiana, Inc., Indianapolis 46202.
Am J Reprod Immunol. 1991 Aug;26(1):23-7. doi: 10.1111/j.1600-0897.1991.tb00697.x.
With recent scientific advances leading to better understanding of the immunobiology of recurrent spontaneous abortion (RSA), interest has now focused upon the epidemiology of RSA. A cohort of 214 couples with a history of two or more consecutive abortions were studied for the prevalence of etiologic factors and association with other reproductive failures. The prevalence of causes of RSA in this cohort was compared with etiologic factors among 179 couples with a history of three or more consecutive abortions. The obstetrical histories of 214 women with RSA were analyzed for the total number of pregnancies, live births, stillbirths, spontaneous abortions, ectopic pregnancies, and hydatidiform moles. These numbers were compared with the expected frequency of each in the general population. The prevalence of etiologies among 214 with RSA were as follows: chromosomal-6%, anatomic-1%, hormonal-5%, immunologic-65%, and unexplained-23%. No differences in the prevalence of etiologic factors exist when couples with a history of two or more abortions are compared with three or more abortions. When the number of ectopic pregnancies, molar pregnancies, and stillbirths among 214 women with RSA were compared with the expected numbers, the odds ratios were 2.2 for ectopic pregnancies, 6.0 for molar pregnancies, and 2.3 for stillbirths. These data indicate that no difference in the prevalence of etiologies of RSA exist when couples with two or more abortions are compared with three or more and a comorbidity between RSA and other types of reproductive failure exists.
随着近期科学进展使人们对复发性自然流产（RSA）的免疫生物学有了更好的理解，现在人们的兴趣集中在了RSA的流行病学上。对214对有两次或更多次连续流产史的夫妇进行了研究，以了解病因因素的患病率及其与其他生殖失败的关联。将该队列中RSA的病因患病率与179对有三次或更多次连续流产史的夫妇的病因因素进行了比较。分析了214名患有RSA的女性的产科病史，包括妊娠总数、活产、死产、自然流产、异位妊娠和葡萄胎。将这些数字与一般人群中每种情况的预期频率进行了比较。214名患有RSA的患者中病因的患病率如下：染色体异常-6%，解剖学因素-1%，激素因素-5%，免疫因素-65%，不明原因-23%。将有两次或更多次流产史的夫妇与有三次或更多次流产史的夫妇进行比较时，病因因素的患病率没有差异。当将214名患有RSA的女性中的异位妊娠、葡萄胎妊娠和死产数量与预期数量进行比较时，异位妊娠的优势比为2.2，葡萄胎妊娠为6.0，死产为2.3。这些数据表明，将有两次或更多次流产史的夫妇与有三次或更多次流产史的夫妇进行比较时，RSA病因的患病率没有差异，并且RSA与其他类型的生殖失败之间存在合并症。
