The Recurrent Pregnancy Loss Unit, The Capital Region, Copenhagen University Hospitals, Hvidovre Hospital, DK-2650, Rigshospitalet, Copenhagen DK-2100, Denmark.
The Recurrent Pregnancy Loss Unit, The Capital Region, Copenhagen University Hospitals, Hvidovre Hospital, DK-2650, Rigshospitalet, Copenhagen DK-2100, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark.
J Reprod Immunol. 2024 Sep;165:104297. doi: 10.1016/j.jri.2024.104297. Epub 2024 Jul 14.
Recurrent pregnancy loss (RPL) affects 1-2 % of all couples trying to conceive and is a challenging heterogeneous condition. This study aimed to evaluate the prevalence and impact of various risk factors in patients suffering from RPL. We performed a prospective cohort study including patients at the tertiary RPL Unit in the Capital Region of Denmark between 1st January 2000 and 1st January 2023. The main outcome of the study was the first pregnancy after referral and whether the pregnancy was ongoing at least to the 22nd gestational week. A total of 2555 patients were included in the study, out of whom 1892 patients achieved a pregnancy after referral to the RPL Unit. This resulted in 1103 live births (58.3 %) and 718 pregnancy losses (37.9 %). Maternal age, BMI, smoking status and the number of prior pregnancy losses were negatively correlated with the likelihood of achieving pregnancy. Furthermore, maternal age, prior pregnancy losses, antiphospholipid syndrome (APS) and uterine malformations were associated with reduced birth rates. Patients with secondary RPL had a higher birth rate compared to those with primary RPL, and patients with APS treated with low-molecular-weight heparin (LMWH) demonstrated a significantly increased birth rate compared to untreated APS patients. These findings suggest that certain risk factors significantly impact the likelihood of achieving pregnancy and live birth following RPL, which can be used in patient guidance.
复发性流产（RPL）影响所有试图怀孕的夫妇的 1-2%，是一种具有挑战性的异质性疾病。本研究旨在评估患有 RPL 的患者中各种风险因素的流行率和影响。我们进行了一项前瞻性队列研究，包括丹麦首都地区三级 RPL 单位在 2000 年 1 月 1 日至 2023 年 1 月 1 日期间的患者。本研究的主要结果是转诊后的第一次妊娠，以及妊娠是否至少持续到第 22 个妊娠周。共有 2555 名患者纳入本研究，其中 1892 名患者在转诊至 RPL 单位后成功妊娠。这导致 1103 例活产（58.3%）和 718 例妊娠丢失（37.9%）。母亲年龄、BMI、吸烟状况和既往妊娠丢失次数与妊娠的可能性呈负相关。此外，母亲年龄、既往妊娠丢失、抗磷脂综合征（APS）和子宫畸形与出生率降低有关。继发性 RPL 患者的出生率高于原发性 RPL 患者，接受低分子量肝素（LMWH）治疗的 APS 患者的出生率明显高于未接受治疗的 APS 患者。这些发现表明，某些风险因素对 RPL 后妊娠和活产的可能性有重大影响，可以用于患者指导。
