Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey.
Hum Antibodies. 2022;30(2):59-65. doi: 10.3233/HAB-211517.
The rates of pregnancy losses (PLs) are increased by maternal risk factors such as autoimmune disorders (AD) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms.
To evaluate singleton PLs before gestational week (gw) 22 among patients with AD and MTHFR polymorphisms.
Totally, 1108 singleton pregnancies in 243 women were categorized as: 1) 148 pregnancies in 33 patients with AD, 2) 316 pregnancies in 66 patients with MTHFR polymorphisms, 3) 644 pregnancies in 144 patients with AD +MTHFR polymorphisms. PLs were classified into subgroups: a) Chemical Pregnancy(CP), b) Blighted Ovum(BO), c) gw ⩽ 10, d) gw11-14 e) gw15-22, f) Ectopic Pregnancy(EP), g) Trophoblastic Disease(TD). Obstetric histories were compared using Beksac Obstetrics Index (BOI): [number of living child + (π/10)]/gravida.
PL rates before gw22 were 39.2% (58/148), 33.2% (105/316), and 36.3% (234/644) in AD, MTHFR, and AD +MTHFR groups, respectively (p= 0.421). The rate of Pre-Prenatal Screening Period fetal losses (CP + BO + gw ⩽ 10 fetal losses + EP + TD) were 84.8%, 75.9%, and 77.8% in AD, MTHFR, and AD +MTHFR, respectively (p= 0.264). Gravidity ⩽ 4 versus those with gravidity ⩾ 5 had statistically significant differences in BOI (p< 0.001).
PL rate before gw22 among singleton pregnancies with AD and/or MTHFR polymorphisms was 35.8%. The clinical findings seem to be more complicated in patients with gravidity ⩾ 5.
妊娠丢失（PL）的发生率因母体自身免疫性疾病（AD）和亚甲基四氢叶酸还原酶（MTHFR）基因多态性等危险因素而增加。
评估 AD 和 MTHFR 多态性患者在妊娠 22 周前的单胎 PL 率。
将 243 名患者的 1108 例单胎妊娠分为 3 组：1）33 名 AD 患者的 148 例妊娠；2）66 名 MTHFR 多态性患者的 316 例妊娠；3）144 名 AD+MTHFR 多态性患者的 644 例妊娠。PL 分为亚组：a）生化妊娠（CP），b）空孕囊（BO），c）妊娠 ⩽ 10 周，d）妊娠 11-14 周，e）妊娠 15-22 周，f）异位妊娠（EP），g）滋养细胞疾病（TD）。使用 Beksac 产科指数（BOI）比较产科史：[活产子女数+（π/10）]/孕次。
AD、MTHFR 和 AD+MTHFR 组在妊娠 22 周前的 PL 率分别为 39.2%（58/148）、33.2%（105/316）和 36.3%（234/644）（p=0.421）。在 AD、MTHFR 和 AD+MTHFR 组中，产前筛查期胎儿丢失率（CP+BO+妊娠 ⩽ 10 周+EP+TD）分别为 84.8%、75.9%和 77.8%（p=0.264）。孕次 ⩽4 与孕次 ⩾5 之间 BOI 有统计学显著差异（p<0.001）。
AD 和/或 MTHFR 多态性单胎妊娠妊娠 22 周前 PL 率为 35.8%。孕次 ⩾5 的患者临床情况似乎更为复杂。
