Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.
Eur J Obstet Gynecol Reprod Biol. 2024 Sep;300:202-205. doi: 10.1016/j.ejogrb.2024.07.018. Epub 2024 Jul 10.
Short inter-pregnancy interval (IPI) of <18 months following a live birth, has been associated with adverse pregnancy outcome. This study aimed to evaluate whether a short IPI following a medically treated missed abortion (MA) poses similar perinatal risks in a subsequent pregnancy.
The retrospective analysis included patients with history of an MA at up to 10 weeks of gestation, treated with misoprostol (pgE1) only, and with a documented subsequent live pregnancy (2010-2022). 1110 Patients were allocated into two groups: IPI ≤18 months and IPI >18 months. The primary outcome was the risk for a spontaneous preterm birth (PTB) <37 weeks of gestation in the consecutive pregnancy. Secondary outcomes included maternal and neonatal adverse outcomes. Statistical analysis was performed using the Statistical Program for Social Sciences for Windows version 26 (SPSS Inc, Chicago, IL).
The cohort included 1,110 patients: 430 (38.74 %) patients with IPI <18 months and 680 (61.26 %) patients with IPI >18 months. The characteristics of the two groups were not significantly different. The rates of spontaneous PTB <37 and <34 weeks of gestation were significantly higher in the short vs. long IPI cohort (16.28 % vs. 7.06 % and 6.74 % vs. 5.0 %, respectively, p < 0.05). These patients also had a higher risk for Cesarean delivery (31.63 % vs. 23.34 %, p = 0.005) and postpartum hemorrhage (4.42 % vs. 2.06 %, p = 0.029) compared to patients with IPI >18 months. The observed differences remained statistically significant even after adjusting for potential confounding variables using multiple regression analysis. No other significant differences in neonatal or maternal outcomes were noted.
Short IPI (≤18 months) following a medical treatment MA may be associated with an increased risk of PTB, Cesarean delivery and PPH.
妊娠间隔时间（inter-pregnancy interval，IPI）短于 18 个月与活产后不良妊娠结局有关。本研究旨在评估在随后的妊娠中，药物治疗的难免流产（missed abortion，MA）后短 IPI 是否会带来类似的围产期风险。
这项回顾性分析纳入了在 10 周妊娠内接受米索前列醇（pgE1）治疗的 MA 病史患者，且有后续活产妊娠的记录（2010-2022 年）。1110 名患者被分为两组：IPI≤18 个月和 IPI＞18 个月。主要结局是连续妊娠中自发性早产（preterm birth，PTB）＜37 周的风险。次要结局包括母婴不良结局。统计分析使用 Windows 版 Statistical Program for Social Sciences 26 版（SPSS Inc，芝加哥，IL）进行。
该队列包括 1110 名患者：430 名（38.74%）患者 IPI＜18 个月，680 名（61.26%）患者 IPI＞18 个月。两组的特征无显著差异。与长 IPI 组相比，短 IPI 组自发性 PTB＜37 周和＜34 周的发生率明显更高（16.28% vs. 7.06%和 6.74% vs. 5.0%，p＜0.05）。这些患者的剖宫产率（31.63% vs. 23.34%，p=0.005）和产后出血率（4.42% vs. 2.06%，p=0.029）也更高。与 IPI＞18 个月的患者相比，这些差异在使用多元回归分析调整潜在混杂变量后仍具有统计学意义。未观察到新生儿或母婴结局的其他显著差异。
药物治疗 MA 后 IPI 较短（≤18 个月）可能与 PTB、剖宫产和 PPH 风险增加相关。
