Wedenoja Satu, Pihlajamäki Mika, Gissler Mika, Wedenoja Juho, Öhman Hanna, Heinonen Seppo, Kere Juha, Kääriäinen Helena, Tanner Laura
Information Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland.
Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Int J Gynaecol Obstet. 2025 Jan;168(1):326-332. doi: 10.1002/ijgo.15828. Epub 2024 Jul 26.
To study whether gynecologic or reproductive disorders show association with trisomic conceptions.
This nationwide cohort study utilized the Registry of Congenital Malformations to identify women who had a trisomic pregnancy (n = 5784), either with trisomy 13 (T13; n = 351), trisomy 18 (T18; n = 1065) or trisomy 21 (T21; n = 4369) from 1987 to 2018. We used the Finnish Maternity cohort to match the cases to population controls (n = 34 422) on the age, residence, and timing of pregnancy. These data were cross-linked to the ICD-10 diagnoses of the national Care Registry for Health Care data on specialized health care in Finland during 1996 to 2019. Both inflammatory (ICD-10 diagnoses: N70-N77) and noninflammatory disorders of the genital tract (N80-N98) were studied. Crude odds ratios (ORs) with 95% CIs were calculated for associations between diagnoses and trisomic conceptions.
The diagnosis of female infertility (N97) at any time was associated with trisomic conceptions (OR: 1.19, 95% CI: 1.08-1.32). In the subgroup analysis, this association was found for T18 (OR: 1.29, 95% CI: 1.03-1.61) and T21 (OR: 1.17, 95% CI: 1.04-1.32), but not for T13 (OR: 1.15, 95% CI: 0.75-1.72). When restricting the timing of the diagnosis of female infertility, an elevated OR was found only after the index pregnancy (OR: 1.81, 95% CI: 1.56-2.09). These increased odds for infertility after trisomic conceptions were observed both in women <35 years (T18 OR: 1.91, 95% CI: 1.21-3.00; T21 OR: 1.68, 95% CI: 1.31-2.14) and in women ≥35 years (T18 OR: 2.17, 95% CI: 1.40-3.33; T21 OR: 1.87; 95% CI: 1.47-2.39), but not after T13 conceptions.
Our observational data suggest a link between trisomic conceptions and subsequent diagnoses of infertility but do not demonstrate causality. These data implicate that partially similar mechanisms might predispose to trisomy and infertility, regardless of maternal age.
研究妇科或生殖系统疾病是否与三体妊娠相关。
这项全国性队列研究利用先天性畸形登记处，确定了1987年至2018年期间怀有三体妊娠（n = 5784）的女性，其中13三体（T13；n = 351）、18三体（T18；n = 1065）或21三体（T21；n = 4369）。我们使用芬兰孕产妇队列，根据年龄、居住地和妊娠时间，将病例与人群对照（n = 34422）进行匹配。这些数据与1996年至2019年期间芬兰国家医疗保健专门医疗保健数据的ICD - 10诊断进行了交叉链接。研究了生殖道的炎症性（ICD - 10诊断：N70 - N77）和非炎症性疾病（N80 - N98）。计算了诊断与三体妊娠之间关联的粗比值比（OR）及95%置信区间（CI）。
任何时候的女性不孕症诊断（N97）与三体妊娠相关（OR：1.19，95% CI：1.08 - 1.32）。在亚组分析中，发现这种关联存在于T18（OR：1.29，95% CI：1.03 - 1.61）和T21（OR：1.17，95% CI：1.04 - 1.32）中，但不存在于T13中（OR：1.15，95% CI：0.75 - 1.72）。当限制女性不孕症诊断的时间时，仅在索引妊娠后发现OR升高（OR：1.81，95% CI：1.56 - 2.09）。在<35岁的女性（T18 OR：1.91，95% CI：1.21 - 3.00；T21 OR：1.68，95% CI：1.31 - 2.14）和≥35岁的女性（T18 OR：2.17）中均观察到三体妊娠后不孕症几率增加，95% CI：（1.40 - 3.33）；T21 OR：1.87；95% CI：1.47 - 2.39），但在T13妊娠后未观察到。
我们的观察数据表明三体妊娠与随后的不孕症诊断之间存在联系，但未证明因果关系。这些数据表明，无论母亲年龄如何，部分相似的机制可能使个体易患三体症和不孕症。
