Chen Rongzhou, Xu Haohan, Hou Yujia, Liu Hanghang, Zheng Zheng, Ma Shaohua
Tsinghua Shenzhen International Graduate, Tsinghua University, Shenzhen 518055, China.
Tsinghua-Berkeley Shenzhen Institute, Shenzhen 518055, China.
Life Med. 2023 Dec 8;2(6):lnad049. doi: 10.1093/lifemedi/lnad049. eCollection 2023 Dec.
Recurrent spontaneous abortion (RSA) affects 2%-5% of couples worldwide and remains a subject of debate regarding the effectiveness of lymphocyte immunotherapy (LIT) due to limited retrospective studies. We conducted a comprehensive Bayesian analysis to assess the impact of LIT on RSA. Using data from the Shenzhen Maternity and Child Healthcare Hospital (2001-2020, = 2316), a Bayesian generalized linear model with predictive projection feature selection was employed. Our analysis revealed a significant improvement in live birth rates for RSA patients undergoing LIT. Notably, LIT had a greater impact compared to the other 85 factors considered. To mitigate research bias, we conducted a Bayesian meta-analysis combining our dataset with 19 previously reported studies (1985-2021, = 4246). Additionally, we developed an empirical model highlighting the four key factors, which are the LIT result, age, paternal blood type, and anticardiolipin antibody. Younger age (19-27), paternal blood type B, and a positive anticardiolipin antibody (IgM) were associated with better therapeutic outcomes in LIT for RSA. These findings aid clinicians in identifying suitable candidates for LIT and improving treatment outcomes.
复发性自然流产（RSA）影响着全球2%-5%的夫妇，由于回顾性研究有限，淋巴细胞免疫疗法（LIT）的有效性仍是一个有争议的话题。我们进行了一项全面的贝叶斯分析，以评估LIT对RSA的影响。利用深圳市妇幼保健院的数据（2001-2020年，n=2316），采用了具有预测投影特征选择的贝叶斯广义线性模型。我们的分析显示，接受LIT的RSA患者的活产率有显著提高。值得注意的是，与其他85个考虑因素相比，LIT的影响更大。为了减轻研究偏差，我们进行了一项贝叶斯荟萃分析，将我们的数据集与之前报道的19项研究（1985-2021年，n=4246）相结合。此外，我们开发了一个实证模型，突出了四个关键因素，即LIT结果、年龄、父亲血型和抗心磷脂抗体。年龄较小（19-27岁）、父亲血型为B型以及抗心磷脂抗体（IgM）呈阳性与LIT治疗RSA的更好治疗结果相关。这些发现有助于临床医生识别适合接受LIT的患者并改善治疗结果。
