Mianyang Central Hospital, affiliated to School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital), Mianyang, China.
Sci Rep. 2024 Sep 6;14(1):20830. doi: 10.1038/s41598-024-71986-z.
The adverse pregnancy outcomes, including recurrent spontaneous abortion (RSA), are strongly correlated with water-soluble vitamins, but how to predict RSA occurrence using them remains unsatisfactory. This study aims to investigate the possibility of predicting RSA based on the baseline levels of water-soluble vitamins tested by ultra-liquid chromatography-tandem mass spectrometry. A total of 918 pregnant women was consecutively enrolled in this cross-sectional study. According to the miscarriage numbers, they were divided into normal first pregnancy (NFP, n = 608), once spontaneous abortion (OSA, n = 167), and continuous spontaneous abortion (CSA, n = 143) groups. The Cox proportional-hazards regression model was employed to establish a risk model for predicting RSA. The RSA occurrence was 6.54% in overall pregnant women, with a prevalence of 12.57% in the OSA group and 27.27% in the CSA group. Significant differences were observed in baseline deficiencies of vitamin B3, B5, B6, and B9 among NFP, OSA, and CSA groups (χ2 = 12.191 ~ 37.561, all P < 0.001). Among these vitamins, B9 (HR = 0.89 and 0.88, all P < 0.001) and B6 (HR = 0.83 and 0.78, all P < 0.05) were identified as independent factors in both the OSA and CSA groups; whereas B5 was identified as an additional independent factor only in the CSA group (HR = 0.93, P = 0.005). The Cox proportional-hazards model established using these three vitamins exhibited poor or satisfactory predictive performance in the OSA (Sen = 95.2%, Spe = 39.0%) and CSA (Sen = 92.3%, Spe = 60.6%) groups, respectively. However, B5, B6, and B9 compensatory levels were not associated with RSA occurrence (all P > 0.05). Our study presents a highly sensitive model based on mass spectrometry assay of baseline levels in B vitamins to predict the RSA occurrence as possible.
不良妊娠结局，包括复发性自然流产（RSA），与水溶性维生素密切相关，但如何利用它们来预测 RSA 的发生仍不尽如人意。本研究旨在通过超高效液相色谱-串联质谱法检测水溶性维生素的基线水平，探讨预测 RSA 的可能性。
这项横断面研究共纳入了 918 名孕妇。根据流产次数，将其分为正常初产妇（NFP，n=608）、一次自然流产（OSA，n=167）和连续自然流产（CSA，n=143）组。采用 Cox 比例风险回归模型建立预测 RSA 的风险模型。
总体孕妇 RSA 发生率为 6.54%，OSA 组为 12.57%，CSA 组为 27.27%。NFP、OSA 和 CSA 组之间，维生素 B3、B5、B6 和 B9 的基线缺乏率存在显著差异（χ2=12.191~37.561，均 P<0.001）。
在这些维生素中，维生素 B9（OSA 组和 CSA 组的 HR=0.89 和 0.88，均 P<0.001）和 B6（OSA 组和 CSA 组的 HR=0.83 和 0.78，均 P<0.05）被鉴定为 OSA 和 CSA 组的独立因素；而 B5 仅在 CSA 组中被鉴定为另一个独立因素（HR=0.93，P=0.005）。
使用这三种维生素建立的 Cox 比例风险模型在 OSA（Sen=95.2%，Spe=39.0%）和 CSA（Sen=92.3%，Spe=60.6%）组中的预测性能分别为差或良好。然而，B5、B6 和 B9 的补偿水平与 RSA 的发生无关（均 P>0.05）。
我们的研究提供了一个基于基线水平的 B 族维生素质谱分析的高敏感模型，以预测 RSA 的发生。
