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不明原因复发性流产患者的持续妊娠:不良产科结局

Ongoing pregnancies in patients with unexplained recurrent pregnancy loss: adverse obstetric outcomes.

作者信息

Cozzolino Mauro, Rizzello Francesca, Riviello Chiara, Romanelli Chiara, Coccia Elisabetta Maria

机构信息

a Instituto Valenciano de Infertilidad, IVI-RMA Global , Madrid , Spain.

b Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynecology, University of Florence , Florence , Italy.

出版信息

Hum Fertil (Camb). 2019 Sep;22(3):219-225. doi: 10.1080/14647273.2018.1475754. Epub 2018 May 25.

Abstract

To investigate the incidence of adverse pregnancy outcomes in couples with an unexplained Recurrent Pregnancy Loss (RPL) history, a retrospective cohort study was conducted between 2014 and 2015. The study group (A) included couples with an unexplained RPL, and the control group (B) was composed of couples who attended the Low-Risk Antenatal Unit during the same period. On the other hand, 53 couples were included in the study group (A) and on the other hand, 65 in the control group (B). Women with previous unexplained recurrent pregnancies loss had a significantly increased risk of gestational diabetes with 12 cases (22.6%) in the study group and 3 cases (4.6%) in the control (OR: 6.048; 95% CI: 1.607-22.762;  = 0.007). A slight increase in the risk of preterm delivery and hepatic cholestasis was observed in the study group (6 cases, 11.3%, in study group and 1 case, 1.5% in the controls (OR: 8.170; 95% CI: 0.951-70.158;  = 0.0555). Women with a history of RPL delivered more frequently by caesarean section (OR: 3.252; 95% CI: 1.460-7.241;  = 0.0039). Women with a history of RPL were at an increased risk for adverse pregnancy outcomes, mainly gestational diabetes. Therefore, a closer surveillance during the antenatal period is recommended in this group of patients.

摘要

为调查有不明原因复发性流产(RPL)病史的夫妇中不良妊娠结局的发生率,于2014年至2015年进行了一项回顾性队列研究。研究组(A)包括有不明原因RPL的夫妇,对照组(B)由同期在低风险产前病房就诊的夫妇组成。另一方面,研究组(A)纳入了53对夫妇,对照组(B)纳入了65对夫妇。既往有不明原因复发性流产的女性患妊娠期糖尿病的风险显著增加,研究组有12例(22.6%),对照组有3例(4.6%)(比值比:6.048;95%可信区间:1.607 - 22.762;P = 0.007)。研究组早产和肝内胆汁淤积的风险略有增加(研究组6例,11.3%,对照组1例,1.5%(比值比:8.170;95%可信区间:0.951 - 70.158;P = 0.0555)。有RPL病史的女性剖宫产分娩的频率更高(比值比:3.252;95%可信区间:1.460 - 7.241;P = 0.0039)。有RPL病史的女性不良妊娠结局的风险增加,主要是妊娠期糖尿病。因此,建议对这组患者在孕期进行更密切的监测。

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