Kralickova Pavlina, Kurecova Barbora, Andrys Ctirad, Krcmova Irena, Jilek Dalibor, Vlkova Marcela, Litzman Jiri
Institute of Clinical Immunology and Allergology, University Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic.
Reprofit International, s.r.o., Hlinky 122/48, 60300, Brno, Czech Republic.
J Clin Immunol. 2015 Aug;35(6):531-7. doi: 10.1007/s10875-015-0188-7. Epub 2015 Aug 18.
The aim of our retrospective study was to clarify fertility, pregnancy complications and outcomes in common variable immunodeficiency (CVID) females.
Retrospective data were obtained from three Czech referral centres. The data were compared with data obtained from the Czech National Registry of Reproduction Health.
Our cohort of patients comprised 54 women with 115 pregnancies; 88 pregnancies in 50 females were finished with live births (77 %). In only 8 women (15%) was the diagnosis of CVID established before the first pregnancy. Replacement immunoglobulin therapy was performed in 10 patients without any moderate or severe adverse effects. Compared with the Czech population, the CVID patients suffered significantly more frequently from the threat of preterm labour (p < 0.0001), vaginal bleeding (p = 0.0001), eclampsia/preeclampsia (p = 0.009) and a higher number of stillbirths (p < 0.0001). Furthermore, the frequency of babies with low birth weight (less than 2500 g) born to the CVID patients was increased compared with the normal population (p < 0.0001). Serum IgG, IgA and IgM determination was done in 57 children of 50 mothers showing 13 cases of IgA deficiency (23%). There was no significant difference among the non-symptomatic, symptomatic untreated and symptomatic treated females in any of the determined gynaecological complications. The number of unsuccessful pregnancies was higher in the symptomatic untreated women.
Fertility in CVID patients is not decreased, and their pregnancies could be considered more risky compared with those of the general population.
我们这项回顾性研究的目的是阐明普通变异型免疫缺陷（CVID）女性的生育能力、妊娠并发症及结局。
回顾性数据来自捷克的三个转诊中心。这些数据与从捷克国家生殖健康登记处获得的数据进行了比较。
我们的患者队列包括54名女性，共115次妊娠；50名女性的88次妊娠以活产告终（77%）。仅8名女性（15%）在首次妊娠前被确诊为CVID。10名患者接受了替代免疫球蛋白治疗，未出现任何中度或重度不良反应。与捷克人群相比，CVID患者发生早产威胁（p<0.0001）、阴道出血（p = 0.0001）、子痫/先兆子痫（p = 0.009）的频率显著更高，死产数量也更多（p<0.0001）。此外，与正常人群相比，CVID患者所生低出生体重（低于2500克）婴儿的频率有所增加（p<0.0001）。对50名母亲的57名子女进行了血清IgG、IgA和IgM测定，发现13例IgA缺乏（23%）。在任何已确定的妇科并发症方面，无症状、有症状未治疗和有症状已治疗的女性之间均无显著差异。有症状未治疗的女性中，妊娠失败的数量更高。
CVID患者的生育能力并未降低，但与普通人群相比，她们的妊娠风险可能更高。
