Clinical factors associated with pregnancy outcome in women with recurrent pregnancy loss

Abstract

The aim of this prospective cohort study was to evaluate clinical factors associated with pregnancy outcomes in women with recurrent pregnancy loss (RPL). Women with a history of two or more pregnancy losses underwent workups for clinical factors of RPL and their pregnancies were followed-up with informed consent. Two hundred eleven (81.5%) of 259 women with RPL became pregnant. The multivariable analyses demonstrated that age (p < .01, OR 0.9, 95%CI 0.97–0.83), uterine abnormality (p < .05, OR 0.3, 95%CI 0.11–0.8), and protein C (PC) deficiency (p < .01, OR 0.14, 95%CI 0.03–0.6) were independent factors for becoming pregnancy in women with RPL. The number of previous pregnancy loss (p < .01, OR 0.57, 95%CI 0.43–0.75) and natural killer (NK) cell activity ≥33% (p < .01, OR 0.31, 95%CI 0.13–0.73) were independent factors for live birth in the subsequent pregnancy. Advanced age, the presence of uterine abnormality, and PC deficiency were risk factors for reduced pregnancy rate in women with RPL. Increased number of previous pregnancy loss and high NK cell activity were risk factors for miscarriage in the subsequent pregnancy. These results involve important information and are helpful for clinical practitioners.

摘要

此前瞻性队列研究的目的是为评估与复发性流产（RPL）妇女妊娠结局相关的临床因素。对有两次或两次以上妊娠流产病史的妇女进行与RPL临床因素相关的检查,并在知情同意的情况下对其妊娠进行随访。259例RPL妇女中, 妊娠211例（81.5%）。多变量分析表明：年龄(p<.01, OR 0.9, 95%CI 0.97–0.83), 子宫异常(p＜.05, OR 0.3, 95%CI 0.11-0.8), 蛋白C(PC)缺乏(p＜.01, OR 0.14, 95%CI 0.03-0.6)是RPL妇女妊娠的独立影响因素。流产次数（p<.01, OR 0.57,, 95%CI 0.43–0.75）与自然杀伤（NK）细胞活性≥33% (p<.01, OR 0.31, 95%CI 0.13–0.73)是再次妊娠活产的独立影响因素。高龄、子宫异常和PC缺乏是RPL妇女妊娠率下降的危险因素。流产次数多、NK细胞活性高是再次妊娠流产的危险因素。这些结果包含重要信息并对临床实践有很大帮助。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• miscarriage
• pregnancy
• recurrent pregnancy loss
• protein C deficiency
• natural killer cell activity
• uterine abnormality

Disclosure statement

None of the authors have any conflicts of interest to declare.

Additional information

Funding

This work was supported in part by Grant-in-Aids from the Japan Society for the Promotion of Science under Grant No.17K11235 and the Japan Agency for Medical Research and Development under Grant No. 17gk0110018s0102.