肥胖和血栓形成倾向对行体外受精的女性流产风险的影响。

Effects of Obesity and Thrombophilia on the Risk of Abortion in Women Undergoing Fertilization.

机构信息

Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy.

Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy.

出版信息

Front Endocrinol (Lausanne). 2020 Dec 23;11:594867. doi: 10.3389/fendo.2020.594867. eCollection 2020.

DOI:10.3389/fendo.2020.594867

PMID:33424770

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7786836/

Abstract

INTRODUCTION

Obesity is associated with a higher risk of abortion in women undergoing fertilization (IVF). Whether thrombophilia amplifies this risk is currently unclear. The aim of this study was to evaluate the effects of thrombophilia on the risk of abortion in obese women treated with IVF.

METHODS

Patient characteristics, presence of inherited or acquired thrombophilia, and comorbidities were prospectively collected before the procedure in consecutive women undergoing IVF. The primary outcome was the incidence of abortion among women who achieved a clinical pregnancy.

RESULTS

A total of 633 non-obese and 49 obese Caucasian women undergoing IVF were included. 204 (32%) women achieved clinical pregnancy, of whom six had an ectopic pregnancy and 63 experienced an abortion. The incidence of abortion was higher in obese women compared to non-obese women after adjusting for age (64.3% vs. 29.3%, odds ratio [OR] 4.41; 95% CI 1.41 to 13.81). Women with one or more thrombophilia were at increased risk of abortion relative to those without thrombophilia (OR 2.70; 95% CI 1.34 to 5.45), and the risk seemed to be higher with hereditary (OR 5.12; 95% CI 1.77 to 14.8) than acquired thrombophilia (OR 1.92; 95% CI 0.52 to 5.12; p for interaction 0.194). Among obese women, the presence of one or more thrombophilia seemed associated with a substantially increased risk of abortion (unadjusted OR 14.00; 95% CI 0.94 to 207.6).

CONCLUSIONS

Obese women undergoing IVF have a high risk of abortion which seems further amplified by the concomitant presence of thrombophilia.

摘要

简介

肥胖与接受体外受精（IVF）的女性流产风险增加有关。目前尚不清楚血栓形成倾向是否会放大这种风险。本研究旨在评估血栓形成倾向对接受 IVF 治疗的肥胖女性流产风险的影响。

方法

在连续接受 IVF 的女性中，前瞻性地收集了患者特征、遗传性或获得性血栓形成倾向以及合并症的存在情况。主要结局是临床妊娠女性的流产发生率。

结果

共纳入 633 名非肥胖和 49 名肥胖白种人接受 IVF。204 名（32%）女性实现了临床妊娠，其中 6 名患有宫外孕，63 名发生流产。调整年龄后，肥胖女性的流产发生率高于非肥胖女性（64.3%比 29.3%，比值比[OR]4.41；95%置信区间[CI]1.41 至 13.81）。与无血栓形成倾向的女性相比，具有一种或多种血栓形成倾向的女性发生流产的风险更高（OR 2.70；95%CI 1.34 至 5.45），遗传性血栓形成倾向（OR 5.12；95%CI 1.77 至 14.8）的风险似乎高于获得性血栓形成倾向（OR 1.92；95%CI 0.52 至 5.12；交互作用的 p 值为 0.194）。在肥胖女性中，存在一种或多种血栓形成倾向似乎与流产风险显著增加相关（未调整的 OR 14.00；95%CI 0.94 至 207.6）。