妊娠早期自然流产组织染色体异常情况及其相关因素分析  

Chromosome abnormality rate and related factors of spontaneous abortion in early pregnancy

作　　者：沈鉴东 孙方西 瞿殿云 谢佳孜 高莉 仇茜 高超 吴畏 吴春香 汪道武 刁飞杨 刘嘉茵 Sheri Jiandong;Sun Fangxi;Qu Dianyun;Xie Jiazi;Gao Li;Qiu Qian;Gao Chao;Wu Wei;Wu Chunxiang;Wang Daowu;Diao Feiyang;Liu Jiayin(The Center of Reproductive Medicine,the First Affiliated Hospital of Nanjing Medical University,State Key Laboratory of Reproductive Medicine,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院生殖医学中心生殖医学国家重点实验室,210029

出　　处：《中华妇产科杂志》2019年第12期797-802,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：国家重点研发计划(2017YFC1001303、2017YFC1001004);国家自然科学基金(81471429,81730041)。

摘　　要：目的分析早孕期自然流产组织的染色体异常情况及其相关因素。方法收集2015年6月至2018年8月在南京医科大学第一附属医院生殖医学中心就诊的早孕期自然流产患者的流产绒毛或胎儿组织831例,通过二代测序技术(NGS)行染色体拷贝数分析,通过统计学方法分析染色体异常与女方年龄、是否体外受精-胚胎移植(IVF-ET)妊娠、既往自然流产次数、既往有无活产分娩史之间的关系。结果在831例早孕期自然流产组织样本中,发现染色体异常461例(55.5%,461/831)。其中女方年龄(OR=1.107,95%CI为1.070~1.145)和活产分娩史(OR=1.909,95%CI为1.182~3.083)是早孕期自然流产组织染色体异常的正相关因素,既往自然流产次数(OR=0.807,95%CI为0.702~0.928)和IVF-ET妊娠(OR=0.554,95%CI为0.404~0.760)是早孕期自然流产组织染色体异常的负相关因素。结论胚胎染色体异常是早孕期自然流产的重要病因。女方年龄增加、有活产分娩史者染色体异常率增加,而既往自然流产次数增加、IVF-ET妊娠者染色体异常率下降。Objective To investigate chromosome abnormality rate and related factors of spontaneous abortion in early pregnancy.Methods A total of 831 tissue samples of spontaneous abortion in early pregnancy were collected from June 2015 to August 2018 in the First Affiliated Hospital of Nanjing Medical University.Chromosomal copy number was analyzed by next generation sequencing(NGS).The relationships between chromosome abnormality and maternal age,in vitro fertilization-embryo transfer(IVF-ET)pregnancy,number of previous spontaneous abortions,history of live birth were analyzed by statistical methods.Results Among 831 tissue samples of spontaneous abortion in early pregnancy,461(55.5%,461/831)were found to have chromosome abnormalities.Maternal age(OR=1.107,95%CI:1.070-1.145)and history of live birth(OR=1.909,95%CI:1.182-3.083)were the positive correlative factors of chromosome abnormality.Times of previous spontaneous abortion(OR=0.807,95%CI:0.702-0.928)and IVF-ET pregnancy(OR=0.554,95%CI:0.404-0.760)were the negative correlative factors of chromosome abnormality.Conclusions Chromosome abnormality is an important cause of spontaneous abortion in early pregnancy.The rate of chromosome abnormality increases with the increase of maternal age and the history of live birth,and decreases with the increase of number of previous spontaneous abortion and IVF-ET pregnancy.

关 键 词：染色体异常 早孕期 生殖医学中心 活产 早期自然流产 分娩史 胎儿组织 流产次数 

分 类 号：R71[医药卫生—妇产科学]