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遗传因素作为流产的原因。

Genetic factors as a cause of miscarriage.

机构信息

Division of Clinical and Molecular Genetics, Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Mizuho-ku, Nagoya, Japan.

出版信息

Curr Med Chem. 2010;17(29):3431-7. doi: 10.2174/092986710793176302.

Abstract

Aneuploidy in the conceptus or fetus, occurs in 5-10% of all pregnancies and is a common reproductive problem in humans. Most aneuploid conceptuses die in utero, resulting in early pregnancy loss. Causes of recurrent miscarriage may include abnormal chromosomes in either partner, particularly translocations, antiphospholipid antibodies and uterine anomalies. Chromosomal aberrations in parents are a major pre-disposing factor and causative of abortion if carried over to the embryo. The transmission rate in the embryo can be speculated to be about 50%. Embryo morphology, developmental rates, and maternal age are correlated with chromosomal abnormalities. Translocation in either partner is one of the most important causes of recurrent miscarriage and the prognosis of subsequent pregnancy in couples with abnormal embryonic karyotype is poorer than that in couples with normal chromosome karyotypes. As for parents whose karyotypes are normal, the frequency of normal embryonic karyotypes significantly increases with the number of previous abortions and a normal karyotype in a previous pregnancy is a predictor of subsequent miscarriage. Recently, many kinds of genetic polymorphisms have also been found to be associated with recurrent miscarriages. In contrast, preimplantation genetic diagnosis for aneuploidy screening is sometimes performed in patients with unexplained recurrent miscarriages. We review genetic factors as a cause of miscarriage.

摘要

胚胎或胎儿非整倍体的发生率在所有妊娠中占 5-10%,是人类常见的生殖问题。大多数非整倍体胚胎在子宫内死亡,导致早期妊娠丢失。复发性流产的原因可能包括夫妻双方染色体异常,尤其是易位、抗磷脂抗体和子宫异常。父母的染色体畸变是主要的易患因素,如果遗传给胚胎,就会导致流产。胚胎中的染色体畸变的传播率可推测约为 50%。胚胎形态、发育速度和母亲年龄与染色体异常相关。夫妻双方中的易位是复发性流产的最重要原因之一,胚胎染色体异常夫妇的后续妊娠预后比染色体正常夫妇差。对于染色体核型正常的父母来说,随着之前流产次数的增加,正常胚胎核型的频率显著增加,且之前妊娠的正常核型是随后流产的预测因素。最近,还发现许多种遗传多态性与复发性流产有关。相比之下,不明原因复发性流产的患者有时会进行胚胎植入前遗传学诊断以筛查非整倍体。我们综述了遗传因素作为流产的原因。

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