343例复发性流产再次妊娠的妊娠结局影响因素分析  

Analysis of Risk Factors of Subsequent Pregnancy Outcome in 343 Recurrent Spontaneous Abortions

作　　者：林梦园 杨越波[2] 廖晨怡 叶敏娟[2] LIN Mengyuan;YANG Yuebo;LIAO Chenyi(Shenzhen People’s Hospital,Shenzhen 518020,China)

机构地区：[1]广东省深圳市人民医院,广东深圳518020 [2]中山大学附属第三医院

出　　处：《中国医学创新》2019年第9期15-19,共5页Medical Innovation of China

摘　　要：目的:研究中山大学附属第三医院妇产科就诊的再次妊娠复发性流产病例的妊娠结局影响因素,从而为临床诊治提供参考依据。方法:收集2007年10月-2017年9月中山大学附属第三医院妇产科门诊或住院部诊治的复发性流产再次妊娠妇女的临床资料,将病例按照妊娠结局分为流产组和活产组。将活产组和流产组先兆流产症状、孕早期宫腔积液、夫或妻染色体异常、先天性子宫发育异常、后天性子宫病变、宫颈机能不全、生殖道感染、内分泌因素、APS抗体阳性、不明原因等项目进行比较。结果:流产组先兆流产症状、孕早期宫腔积液、染色体异常、先天性子宫发育异常、宫颈机能不全、APS抗体阳性6个项目中的比例均高于活产组,差异均有统计学意义(P<0.05)。将以上6项有统计学意义的因素作自变量行Logistic二元回归分析,发现先兆流产症状(X_1)、孕早期宫腔积液(X_2)、宫颈机能不全(X_5),进入最终方程,它们的P值分别为0.02、<0.001、0.01,OR值即Exp(B)分别为2.12、9.76、2.97。结论:RSA患者再次妊娠时,出现先兆流产症状、孕早期宫腔积液是再次流产的预测指标;而合并染色体异常、先天性子宫发育异常、宫颈机能不全、APS相关抗体阳性者可能易发生再次流产,其中宫颈机能不全是RSA妇女再次妊娠流产的独立危险因素。Objective:To study the influencing factors of subsequent pregnancy outcomes in recurrent spontaneous abortion,so as to provide reference for clinical diagnosis and treatment.Method:The clinical data of a total of 343 pregnant women following a history of recurrent spontaneous abortion who diagnosed in the Obstetrics and Gynaecology Department of the Third Affiliated Hospital of Sun Yat-sen University from October 2007 to September 2017 were collected.The cases were divided into abortion group and live birth group according to the pregnancy outcome.Different risk factors were compared between two groups.Result:The differences between two groups in threatened abortion symptoms,early uterine effusion,chromosomal abnormalities,congenital uterine dysplasia,cervical insufficiency,and APS antibody positive were statistically significant(P<0.05),and the proportion of the above six factors in the abortion group were higher than those in the live birth group.The above six statistically significant factors were used as Logistic binary regression analysis.The symptoms of threatened abortion symptoms(X1),early uterine effusion(X2),and cervical insufficiency(X5)were found in the final equation.The P values were 0.02,<0.001,0.01,and the OR values were 2.12,9.76,2.97.Conclusion:RSA patients in their subsequent pregnancy with threaten abortion symptoms,early pregnancy uterine effusion are predictors of re-abortion.And chromosomal abnormalities,congenital uterine dysplasia,cervical insufficiency,APS-related antibodies may be prone to recurrent miscarriage,cervical insufficiency is an independent risk factor for another abortion in RSA women.

关 键 词：复发性流产 妊娠结局 危险因素 

分 类 号：R714.21[医药卫生—妇产科学]