Department of Obstetrics and Gynecology, Fortaleza University (UNIFOR), Fortaleza, Brazil.
Department of Obstetrics and Gynecology, Federal University of Bahia (UFBA), Salvador, Brazil.
Am J Reprod Immunol. 2018 Jun;79(6):e12833. doi: 10.1111/aji.12833. Epub 2018 Feb 22.
To evaluate the predictors of successful pregnancies in women with a history of recurrent miscarriages (RMs) having undergone lymphocyte immunotherapy (LIT).
Retrospective, multicenter, observational study which involved 702 pregnant women with history of RM treated with LIT. Comparative analysis of women with a history of RM having undergone LIT and experienced treatment success vs those having experienced treatment failure along with the analysis of the association between the number of prior miscarriages and the efficacy of LIT.
A total of 421 women were able to carry the pregnancy to term, with treatment success rate of 60%. The multivariate analysis showed that age, the association between autoantibodies and thrombophilia, and the number of previous miscarriages were factors associated with LIT failure. Secondary RMs alone were not found to be a factor predictive of LIT success or failure; however, secondary RMs among women with a history of 5 or more RM were found to be a predictor of LIT success (OR: 10.24; 95% CI: 1.9-55.8; P = .007).
Age, the number of previous miscarriages, and the association between autoantibodies and thrombophilia are associated with LIT failure. A higher number of previous miscarriages in cases of secondary RM resulted in better LIT outcomes.
评估有复发性流产（RM）病史并接受淋巴细胞免疫治疗（LIT）的女性成功妊娠的预测因素。
回顾性、多中心、观察性研究，涉及 702 名有 RM 病史并接受 LIT 治疗的孕妇。对接受 LIT 治疗且治疗成功的 RM 病史女性与治疗失败的女性进行比较分析，并分析既往流产次数与 LIT 疗效之间的关系。
共有 421 名女性能够将妊娠维持至足月，治疗成功率为 60%。多变量分析显示，年龄、自身抗体与血栓形成倾向的关系以及既往流产次数是与 LIT 失败相关的因素。单独的继发性 RM 并未被发现是 LIT 成功或失败的预测因素；然而，有 5 次或更多 RM 病史的女性中的继发性 RM 被发现是 LIT 成功的预测因素（OR：10.24；95%CI：1.9-55.8；P=0.007）。
年龄、既往流产次数以及自身抗体与血栓形成倾向的关系与 LIT 失败相关。在继发性 RM 中，既往流产次数越多，LIT 结局越好。
