Reproductive Medicine Center, Second Hospital of Lanzhou University, No.82, Cuiying Road, Chengguan District, Lanzhou, 730030, Gansu Province, China.
BMC Pregnancy Childbirth. 2024 Mar 25;24(1):219. doi: 10.1186/s12884-024-06422-1.
At present, individualized interventions can be given to patients with a clear etiology of pregnancy loss to improve the subsequent pregnancy outcomes, but the current reproductive status of the patient cannot be changed. The aim of this study was to investigate the association between female reproductive status and subsequence pregnancy outcome in patients with prior pregnancy loss (PL).
A prospective, dynamic population cohort study was carried out at the Second Hospital of Lanzhou University. From September 2019 to February 2022, a total of 1955 women with at least one previous PL were enrolled. Maternal reproductive status and subsequent reproductive outcomes were recorded through an electronic medical record system and follow-up. Logistic regression was used to evaluate the association between reproductive status and the risk of subsequent reproductive outcomes.
Among all patients, the rates of subsequent infertility, early PL, late PL, and live birth were 20.82%, 24.33%, 1.69% and 50.77% respectively. In logistic regression, we found that age (OR 1.08, 95% CI 1.04-1.13) and previous cesarean delivery history (OR 2.46, 95% CI 1.27-4.76) were risk factors for subsequent infertility in patients with PL. Age (OR 1.06, 95% CI 1.03-1.10), age at first pregnancy (OR 1.06, 95% CI 1.03-1.10), BMI (OR 1.06, 95% CI 1.02-1.11), previous PL numbers (OR 1.18, 95% CI 1.04-1.57) and without pre-pregnancy intervention (OR 1.77, 95% CI 1.35-2.24) were risk factors for non-live birth. Age (OR 1.06, 95% CI 1.03-1.09), age at first pregnancy (OR 1.06, 95% CI 1.02-1.09), BMI (OR 1.07, 95% CI 1.02-1.11), previous PL numbers (OR 1.15, 95% CI 1.02-1.31) and without pre-pregnancy intervention (OR 2.16, 95% CI 1.65-2.84) were risk factors for PL.
The reproductive status of people with PL is strongly correlated with the outcome of subsequent pregnancies. Active pre-pregnancy intervention can improve the subsequent pregnancy outcome.
This study was registered in the Chinese Clinical Trial Registry with the registration number of ChiCTR2000039414 (27/10/2020).
目前，可以针对有明确病因的妊娠丢失患者进行个体化干预，以改善后续妊娠结局，但患者目前的生殖状态无法改变。本研究旨在探讨妊娠丢失（PL）患者的女性生殖状态与后续妊娠结局之间的关系。
这是一项在兰州大学第二医院进行的前瞻性、动态人群队列研究。2019 年 9 月至 2022 年 2 月，共纳入 1955 名至少有一次 PL 史的女性。通过电子病历系统和随访记录产妇的生殖状态和后续生殖结局。采用 logistic 回归评估生殖状态与后续生殖结局风险之间的关系。
所有患者中，后续不孕、早期 PL、晚期 PL 和活产的发生率分别为 20.82%、24.33%、1.69%和 50.77%。logistic 回归分析发现，年龄（OR 1.08，95%CI 1.04-1.13）和剖宫产史（OR 2.46，95%CI 1.27-4.76）是 PL 患者后续不孕的危险因素。年龄（OR 1.06，95%CI 1.03-1.10）、初孕年龄（OR 1.06，95%CI 1.03-1.10）、BMI（OR 1.06，95%CI 1.02-1.11）、PL 次数（OR 1.18，95%CI 1.04-1.57）和无孕前干预（OR 1.77，95%CI 1.35-2.24）是活产的危险因素。年龄（OR 1.06，95%CI 1.03-1.09）、初孕年龄（OR 1.06，95%CI 1.02-1.09）、BMI（OR 1.07，95%CI 1.02-1.11）、PL 次数（OR 1.15，95%CI 1.02-1.31）和无孕前干预（OR 2.16，95%CI 1.65-2.84）是 PL 的危险因素。
PL 患者的生殖状态与后续妊娠结局密切相关。积极的孕前干预可以改善后续妊娠结局。
本研究在中国临床试验注册中心注册，注册号为 ChiCTR2000039414（27/10/2020）。
