Christiansen O B, Mathiesen O, Husth M, Lauritsen J G, Jersild C, Grunnet N
Department of Clinical Immunology, Aalborg Hospital, Denmark.
Hum Reprod. 1993 Nov;8(11):1843-7. doi: 10.1093/oxfordjournals.humrep.a137945.
In a previous case-control study of women with unexplained recurrent miscarriages we reported that the frequency of women positive for each of the two histocompatibility (HLA) types HLA-DR1, Br and HLA-DR3 was increased in a subset of patients with a history of four or more miscarriages. In the present study we examined whether the increased frequency of the two HLA types in this subset of patients indicated that they would result in a poor pregnancy prognosis. We related pregnancy outcomes to the mothers' HLA-DR type in a prospective study of a well-defined, closely supervised group of 94 women with unexplained recurrent miscarriages who had achieved intra-uterine pregnancy in the course of one of two prospective placebo-controlled trials concerning the efficacy of immunotherapy. Of the patients who were HLA-DR1, Br and/or HLA-DR3 positive 62% miscarried their next pregnancy compared with 29% of the patients negative for the two HLA types [relative risk of miscarriage in the former group = 2.2 (P < 0.002) unadjusted, and 1.8 (P = 0.025) when adjusted for the number of previous miscarriages]. The results suggest that Danish women with unexplained recurrent miscarriages who are positive for HLA-DR1, Br and/or -DR3 display a poorer pregnancy outcome than patients negative for these types.
在之前一项针对不明原因复发性流产女性的病例对照研究中，我们报告称，在有四次或更多次流产史的部分患者中，两种组织相容性（HLA）类型HLA - DR1、Br和HLA - DR3各自呈阳性的女性频率有所增加。在本研究中，我们调查了这部分患者中这两种HLA类型频率的增加是否表明它们会导致不良的妊娠预后。在一项前瞻性研究中，我们将妊娠结局与母亲的HLA - DR类型相关联，该研究对象为94名不明原因复发性流产的女性，她们在两项关于免疫疗法疗效的前瞻性安慰剂对照试验之一过程中实现了宫内妊娠，且该组受到了明确界定和密切监督。在HLA - DR1、Br和/或HLA - DR3呈阳性的患者中，62%在下一次妊娠时流产，而两种HLA类型均为阴性的患者中这一比例为29%[前一组流产的相对风险 = 2.2（P < 0.002），未调整；调整既往流产次数后为1.8（P = 0.025）]。结果表明，HLA - DR1、Br和/或 - DR3呈阳性的丹麦不明原因复发性流产女性的妊娠结局比这些类型呈阴性的患者更差。
