Hossain Nazli, Shamsi Tahir, Khan Nazeer, Naz Arshi
Departments of Obstetrics and Gynecology Unit 2 Biostatistics, Dow University of Health Sciences National Institute of Blood Diseases, Karachi, Pakistan.
J Obstet Gynaecol Res. 2013 Jan;39(1):121-5. doi: 10.1111/j.1447-0756.2012.01925.x. Epub 2012 Jun 13.
The aim of the study was to identify thrombophilic defects in women with a history of recurrent miscarriage.
This was a case-control study in which the cases were women who had undergone spontaneous recurrent pregnancy losses and the controls were women in matched reproductive age groups without any history of miscarriage or pregnancy loss. Both groups of women were identified from our department's high-risk and gynecological outpatient clinics. A total of 52 women with recurrent pregnancy losses and 268 controls were tested for protein C, protein S, factor V Leiden (FVL), antithrombin and anticardiolipin (immunoglobulin M and G) antibodies, and the odds ratio and P-values were calculated.
The mean age was 28.0 ± 4.4 years in the cases and 32.0±8.0years in the controls. The mean number of abortions among women with recurrent losses was 3.40±1.23. The mean parity was 1.04±1.23 (range 1-6), and 3.27±2.51 among controls. Among women with recurrent pregnancy loss, 22 (42%) had first trimester losses, 19 (36%) had second trimester losses, and 11 (21%) women had both first and second trimester losses. Protein C deficiency was identified in three out of 52 cases and 18 out of 268 controls (P-value 0.49), protein S deficiency in two cases and 12 controls (P-value 0.35), factor V Leiden mutation in 10 cases and 27 controls (P = 0.059), antithrombin in one case and 41 controls (P=0.009), and anticardiolipin antibodies in one case and nine controls (P = 0.49).
No significant association between inherited thrombophilia and recurrent pregnancy loss in Pakistani women was found.
本研究旨在确定有复发性流产病史女性的血栓形成倾向缺陷。
这是一项病例对照研究，病例为经历过自然复发性妊娠丢失的女性，对照为年龄匹配、无流产或妊娠丢失病史的生殖年龄组女性。两组女性均来自本部门的高危和妇科门诊。对总共52例复发性妊娠丢失女性和268例对照进行了蛋白C、蛋白S、因子V莱顿（FVL）、抗凝血酶和抗心磷脂（免疫球蛋白M和G）抗体检测，并计算了比值比和P值。
病例组的平均年龄为28.0±4.4岁，对照组为32.0±8.0岁。复发性流产女性的平均流产次数为3.40±1.23次。平均产次病例组为1.04±1.23（范围1 - 6），对照组为3.27±2.51。在复发性妊娠丢失女性中，22例（42%）为孕早期丢失，19例（36%）为孕中期丢失，11例（21%）女性孕早期和孕中期均有丢失。52例病例中有3例被鉴定为蛋白C缺乏，268例对照中有18例（P值0.49）；2例病例和12例对照为蛋白S缺乏（P值0.35）；10例病例和27例对照存在因子V莱顿突变（P = 0.059）；1例病例和41例对照存在抗凝血酶缺乏（P = 0.009）；1例病例和9例对照存在抗心磷脂抗体（P = 0.49）。
在巴基斯坦女性中，未发现遗传性血栓形成倾向与复发性妊娠丢失之间存在显著关联。
