Wagner Marise M, Visser Jantien, Verburg Harjo, Hukkelhoven Chantal W P M, Van Lith Jan M M, Bloemenkamp Kitty W M
Department of Obstetrics, Leiden University Medical Center, Leiden, the Netherlands.
Department of Reproductive Medicine, Leiden University Medical Center, Leiden, the Netherlands.
Acta Obstet Gynecol Scand. 2018 Jan;97(1):82-88. doi: 10.1111/aogs.13248. Epub 2017 Nov 21.
The cause of recurrent pregnancy loss often remains unknown. Possibly, pathophysiological pathways are shared with other pregnancy complications.
All women with secondary recurrent pregnancy loss (SRPL) visiting Leiden University Medical Center (January 2000-2015) were included in this retrospective cohort to assess whether women with SRPL have a more complicated first pregnancy compared with control women. SRPL was defined as three or more consecutive pregnancy losses before 22 weeks of gestation, with a previous birth. The control group consisted of all Dutch nullipara delivering a singleton (January 2000-2015). Information was obtained from the Dutch Perinatal Registry. Outcomes were preeclampsia, preterm birth, post-term birth, intrauterine growth restriction, breach position, induction of labor, cesarean section, congenital abnormalities, perinatal death and severe hemorrhage in the first ongoing pregnancy. Subgroup analyses were performed for women with idiopathic SRPL and for women ≤35 years.
In all, 172 women with SRPL and 1 196 178 control women were included. Women with SRPL were older and had a higher body mass index; 29.7 years vs. 28.8 years and 25.1 kg/m vs. 24.1 kg/m , respectively. Women with SRPL more often had a post-term birth (OR 1.86, 95% CI 1.10-3.17) and more perinatal deaths occurred in women with SRPL compared with the control group (OR 5.03, 95% CI 2.48-10.2). Similar results were found in both subgroup analyses.
The first ongoing pregnancy of women with (idiopathic) SRPL is more often complicated by post-term birth and perinatal death. Revealing possible links between SRPL and these pregnancy complications might lead to a better understanding of underlying pathophysiology.
复发性流产的病因通常仍不明确。病理生理途径可能与其他妊娠并发症相同。
纳入2000年1月至2015年期间就诊于莱顿大学医学中心的所有继发性复发性流产（SRPL）女性，进行这项回顾性队列研究，以评估SRPL女性与对照女性相比，首次妊娠是否更复杂。SRPL定义为妊娠22周前连续发生三次或更多次流产，且既往有活产史。对照组由2000年1月至2015年期间分娩单胎的所有荷兰未生育女性组成。信息来自荷兰围产期登记处。观察指标为首次持续妊娠中的子痫前期、早产、过期产、胎儿生长受限、臀位、引产、剖宫产、先天性异常、围产期死亡和严重出血。对特发性SRPL女性和年龄≤35岁的女性进行亚组分析。
共纳入172例SRPL女性和1196178例对照女性。SRPL女性年龄更大，体重指数更高，分别为29.7岁对28.8岁，25.1kg/m²对24.1kg/m²。与对照组相比，SRPL女性过期产的发生率更高（比值比[OR]1.86，95%置信区间[CI]1.10 - 3.17），围产期死亡更多（OR 5.03，95%CI 2.48 - 10.2）。在两项亚组分析中均发现了类似结果。
（特发性）SRPL女性的首次持续妊娠更常并发过期产和围产期死亡。揭示SRPL与这些妊娠并发症之间可能的联系，可能有助于更好地理解潜在的病理生理学。
