Fayek Bahi, Liu Yang Doris, Sidhu Arshdeep, Ziafat Kimia, Geerts Maya, AbdelHafez Faten F, Terry Jefferson, Bedaiwy Mohamed A
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
Placenta. 2025 May 2;164:41-48. doi: 10.1016/j.placenta.2025.03.009. Epub 2025 Mar 13.
This study aimed to examine the influence of chronic intervillositis of unknown etiology (CIUE) on reproductive outcomes in patients with recurrent pregnancy loss (RPL), determine treatment effectiveness in future pregnancies, and estimate the CIUE recurrence rate.
This retrospective study examined patients with RPL, categorizing them into CIUE and non-CIUE groups. Impact of CIUE on reproductive outcomes was assessed both cross-sectionally and longitudinally. A log-rank survival analysis was conducted to assess the effectiveness of various treatments on achieving ongoing pregnancies or live births following an initial episode of CIUE. Lastly, CIUE recurrence rate was evaluated.
A total of 394 patients were included in the study: 23 in the CIUE group and 371 in the non-CIUE group. No significant differences were observed between the groups regarding baseline characteristics. Adjusted logistic regression showed that patients with CIUE had higher odds of experiencing preterm birth compared to non-CIUE patients (odds ratio [OR] = 3.15; 95 % confidence interval [CI]: 1.07-9.22). With each additional pregnancy, the non-CIUE group had 75 % increased odds of achieving live birth (OR 1.75; 95 % CI: 1.49-2.06), while the CIUE group's increase was not significant (OR 1.32; 95 % CI: 0.86-2.05). Additionally, the odds of stillbirth associated with additional pregnancies increased by 85 % in the CIUE group (OR 1.85; 95 % CI: 1.03-3.36), yet not significant in the non-CIUE group (OR 1.14; 95 % CI: 0.90-1.45). CIUE-treated patients had higher odds of achieving live birth or ongoing pregnancy after 24 months (P = 0.0491). CIUE recurred in 21.7 % of patients.
In the RPL population, CIUE adversely affected the reproductive outcomes. Despite its high recurrence rate, prophylactic treatment showed potential in improving outcomes.
本研究旨在探讨不明病因慢性绒毛间炎（CIUE）对复发性流产（RPL）患者生殖结局的影响，确定对未来妊娠的治疗效果，并评估CIUE的复发率。
本回顾性研究对RPL患者进行检查，将其分为CIUE组和非CIUE组。从横断面和纵向两方面评估CIUE对生殖结局的影响。进行对数秩生存分析，以评估各种治疗方法对CIUE初次发作后实现持续妊娠或活产的有效性。最后，评估CIUE的复发率。
本研究共纳入394例患者：CIUE组23例，非CIUE组371例。两组间基线特征无显著差异。校正后的逻辑回归显示，与非CIUE患者相比，CIUE患者发生早产的几率更高（优势比[OR]=3.15；95%置信区间[CI]：1.07-9.22）。每增加一次妊娠，非CIUE组实现活产的几率增加75%（OR 1.75；95%CI：1.49-2.06），而CIUE组的增加不显著（OR 1.32；95%CI：0.86-2.05）。此外，CIUE组与额外妊娠相关的死产几率增加了85%（OR 1.85；95%CI：1.03-3.36），而非CIUE组不显著（OR 1.14；95%CI：0.90-1.45）。接受CIUE治疗的患者在24个月后实现活产或持续妊娠的几率更高（P=0.0491）。21.7%的患者CIUE复发。
在RPL人群中，CIUE对生殖结局有不利影响。尽管其复发率高，但预防性治疗在改善结局方面显示出潜力。
