Coste J, Job-Spira N, Fernandez H
INSERM U. 292, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Hum Reprod. 1991 Oct;6(9):1332-7. doi: 10.1093/oxfordjournals.humrep.a137535.
A case-control study was conducted in seven maternity hospitals in the Paris area in 1988 to evaluate the role of several risk factors in spontaneous abortion. A total of 279 cases and 279 controls were compared for socio-demographic characteristics, reproductive history and for conditions of conception. Prior fetal losses [odds ratio (OR) = 2.30 for n greater than or equal to 2; 95% confidence interval (CI) = 1.17-4.61] and maternal age at pregnancy (greater than 30 years) appeared to be major and independent risk factors of spontaneous abortion. Other factors associated with an increased risk of fetal loss were: geographical or ethnic origin (OR = 2.85 for North African women; 95% CI = 1.58-5.10); psychological problems at the time of conception, either related to the outcome of the pregnancy (OR = 3.08; 95% CI = 0.92-10.25) or unrelated to this outcome (OR = 3.35; 95% CI = 1.41-8.00). The following factors were not associated with spontaneous abortion: gravidity, parity, prior induced abortion, prior sexually transmitted diseases and Chlamydia trachomatis serology, menstrual cycle abnormalities, induced conception cycle and in-vitro fertilization, cigarette smoking, current or past use of combined oestrogen/progestagen pill or intrauterine device. These findings confirm the importance of two risk factors for fetal loss: maternal age and number of prior spontaneous abortions. Two risk factors, ethnic origin and psychological problems at the time of conception are also identified, which require further study.
1988年，在巴黎地区的七家妇产医院开展了一项病例对照研究，以评估若干风险因素在自然流产中的作用。对总共279例病例和279名对照者的社会人口学特征、生育史及受孕情况进行了比较。既往有胎儿丢失史（n≥2时比值比[OR]=2.30；95%置信区间[CI]=1.17 - 4.61）以及妊娠时母亲年龄（大于30岁）似乎是自然流产的主要且独立的风险因素。与胎儿丢失风险增加相关的其他因素有：地理或种族出身（北非女性的OR = 2.85；95% CI = 1.58 - 5.10）；受孕时的心理问题，无论是与妊娠结局相关（OR = 3.08；95% CI = 0.92 - 10.25）还是与该结局无关（OR = 3.35；95% CI = 1.41 - 8.00）。以下因素与自然流产无关：妊娠次数、产次、既往人工流产史、既往性传播疾病及沙眼衣原体血清学检查结果、月经周期异常、诱导受孕周期及体外受精、吸烟、当前或过去使用复方雌激素/孕激素避孕药或宫内节育器。这些研究结果证实了胎儿丢失的两个风险因素的重要性：母亲年龄和既往自然流产次数。还确定了两个风险因素，即种族出身和受孕时的心理问题，这需要进一步研究。
