母体中限制HY的人类白细胞抗原II类等位基因与男性胎儿复发性流产后的长期不良结局相关。
Maternal HY-restricting HLA class II alleles are associated with poor long-term outcome in recurrent pregnancy loss after a boy.
作者信息
Kolte Astrid Marie, Steffensen Rudi, Christiansen Ole Bjarne, Nielsen Henriette Svarre
机构信息
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen Rigshospitalet, København Ø, Denmark.
Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.
出版信息
Am J Reprod Immunol. 2016 Nov;76(5):400-405. doi: 10.1111/aji.12561. Epub 2016 Sep 7.
PROBLEM
Women with secondary recurrent pregnancy loss (RPL) after a boy have a reduced chance of live birth in the first pregnancy after referral if they carry HY-restricting HLA class II alleles, but long-term chance of live birth is unknown.
METHODS OF STUDY
Live birth was compared for 540 women with unexplained secondary RPL according to firstborn's sex and maternal carriage of HLA-DRB303:01, HLA-DQB105:01/02, HLA-DRB115, and HLA-DRB107. The groups were compared by Cox proportional hazard ratios.
RESULTS
For women with at firstborn boy, maternal carriage of HY-restricting HLA class II alleles decreased chance of live birth: 0 vs 1: hazard ratio 0.75 (95% CI 0.55-1.02); 0 vs 2: HR 0.62 (0.40-0.94). Carriage of HY-restricting HLA class II alleles decreased chance of live birth only if the firstborn was a boy: boy vs girl: HR 0.72 (95% CI 0.55-0.98).
CONCLUSION
Maternal carriage of HY-restricting HLA class II alleles decreases long-term chance of live birth in women with RPL after a boy.
问题
在经历过一次男孩的继发性复发性流产（RPL）的女性中，如果她们携带限制HY的HLA-II类等位基因，转诊后首次妊娠的活产几率会降低，但长期活产几率尚不清楚。
研究方法
根据头胎性别以及母亲是否携带HLA-DRB303:01、HLA-DQB105:01/02、HLA-DRB115和HLA-DRB107，对540例不明原因继发性RPL的女性的活产情况进行比较。通过Cox比例风险比比较各组情况。
结果
对于头胎为男孩的女性，母亲携带限制HY的HLA-II类等位基因会降低活产几率：0个等位基因与1个等位基因相比：风险比为0.75（95%可信区间0.55 - 1.02）；0个等位基因与2个等位基因相比：风险比为0.62（0.40 - 0.94）。只有当头胎是男孩时，携带限制HY的HLA-II类等位基因才会降低活产几率：男孩与女孩相比：风险比为0.72（95%可信区间0.55 - 0.98）。
结论
母亲携带限制HY的HLA-II类等位基因会降低头胎为男孩的RPL女性的长期活产几率。
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