Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School.
J Nippon Med Sch. 2022 Mar 11;89(1):40-46. doi: 10.1272/jnms.JNMS.2022_89-103. Epub 2021 Apr 19.
Miscarriage occurs in 10-15% of pregnancies and recurrent pregnancy loss (RPL) occurs in 1% of couples hoping for a child. Various risk factors, such as thrombophilia, uterine malformation, and embryonic chromosomal aberration cause RPL. We hypothesized that antithrombotic therapy for RPL patients with thrombophilia would reduce miscarriage due to thrombophilia, which would reduce the total miscarriages and result in a relative increase in miscarriage due to embryonic chromosomal aberrations. In this study, we investigated the incidence of chromosomal aberrations in products of conception in RPL patients with and without antithrombotic therapy.
We performed a single-center, retrospective review of cases diagnosed as miscarriage with embryo chromosome analysis between July 1, 2000, and May 31, 2019. Rates of chromosomal aberration were compared between RPL patients with and without thrombophilia or antithrombotic therapy.
One hundred and-ninety RPL cases were analyzed. The average age was 37.4 ± 4.3 years, and the average number of previous pregnancy losses was 2.2 ± 1.1. The overall chromosomal aberration rate was 67.4% (128/190). There was no difference in the chromosomal aberration rate between the factors for RPL, with or without thrombophilia, and antithrombotic therapy. Only advancing maternal age had significant correlation to increased embryo chromosomal aberration rates.
With or without antithrombotic therapy, miscarriage was caused by embryonic chromosome abnormalities at a certain rate. Antithrombotic therapy in RPL patients with thrombophilia may reduce abortions due to thrombophilia, which may also normalize the rate of embryonic chromosome aberrations in the subsequent miscarriages.
流产发生在 10-15%的妊娠中，而复发性妊娠丢失（RPL）发生在 1%希望生育的夫妇中。各种风险因素，如血栓形成倾向、子宫畸形和胚胎染色体异常导致 RPL。我们假设对有血栓形成倾向的 RPL 患者进行抗血栓治疗将减少因血栓形成引起的流产，从而减少总的流产次数，并导致因胚胎染色体异常引起的流产相对增加。在这项研究中，我们调查了有和没有抗血栓治疗的 RPL 患者的妊娠产物中染色体异常的发生率。
我们对 2000 年 7 月 1 日至 2019 年 5 月 31 日期间因胚胎染色体分析诊断为流产的病例进行了单中心回顾性研究。比较了有和没有血栓形成倾向或抗血栓治疗的 RPL 患者的染色体异常发生率。
分析了 190 例 RPL 病例。平均年龄为 37.4 ± 4.3 岁，平均既往妊娠丢失次数为 2.2 ± 1.1。总体染色体异常率为 67.4%（128/190）。在 RPL 的各种因素中，有或没有血栓形成倾向和抗血栓治疗的染色体异常率没有差异。只有母体年龄的增加与胚胎染色体异常率的增加有显著相关性。
无论是否进行抗血栓治疗，一定比例的流产是由胚胎染色体异常引起的。对有血栓形成倾向的 RPL 患者进行抗血栓治疗可能会减少因血栓形成引起的流产，这也可能使随后流产中胚胎染色体异常的比率正常化。
