Department of Obstetrics and Gynecology, Soroka University Medical Center, Israel.
Am J Obstet Gynecol. 2011 Sep;205(3):286.e1-5. doi: 10.1016/j.ajog.2011.06.053. Epub 2011 Jun 21.
The objective of the study was to determine whether 1 previous miscarriage is associated with an increased rate of adverse pregnancy outcomes in the following pregnancy.
Second pregnancies of women with and without a miscarriage in their initial pregnancy were compared. Multivariable logistic regression models were constructed to control for confounders.
Of 35,125 singleton deliveries in the second pregnancy, 5777 (16.4%) were of patients with an initial miscarriage. Multivariable analysis showed a significant association between a previous miscarriage and the following adverse pregnancy outcomes including premature rupture of membranes (odds ratio [OR], 2.22; 95% confidence interval [CI], 2.01-2.44), preterm delivery (OR, 1.34; 95% CI, 1.21-1.48), intrauterine growth restriction (OR, 1.24; 95% CI, 1.04-1.47), hypertensive disorders (OR 1.41; 95% CI 1.07-1.85), preeclampsia (OR, 1.63; 95% CI, 1.22-2.18), and cesarean delivery (OR, 1.59; 95% CI, 1.46-1.73). Perinatal mortality was significantly higher among women with an initial miscarriage (1.6% vs 1.0%; P < .001).
An initial miscarriage is independently associated with adverse pregnancy outcomes.
本研究旨在确定首次流产是否与随后妊娠的不良妊娠结局发生率增加相关。
比较了初始妊娠有流产史和无流产史的女性的第二胎妊娠。构建多变量逻辑回归模型以控制混杂因素。
在 35125 例第二胎单胎分娩中,有 5777 例(16.4%)为首次流产患者。多变量分析显示,与首次流产相关的不良妊娠结局包括胎膜早破(比值比[OR],2.22;95%置信区间[CI],2.01-2.44)、早产(OR,1.34;95% CI,1.21-1.48)、胎儿生长受限(OR,1.24;95% CI,1.04-1.47)、妊娠期高血压疾病(OR 1.41;95% CI,1.07-1.85)、子痫前期(OR,1.63;95% CI,1.22-2.18)和剖宫产(OR,1.59;95% CI,1.46-1.73)。有初始流产史的女性围产儿死亡率显著升高(1.6%比 1.0%;P<0.001)。
首次流产与不良妊娠结局独立相关。