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Abstract：
UNASSIGNED: To determine the humoral immunity in advanced maternal-age women with recurrent spontaneous abortion (RSA).
UNASSIGNED: A retrospective study was performed between January 2022 and October 2023 in the Department of Reproductive Immunity of Shanghai First Maternity and Infant Hospital. Women with RSA were recruited and multiple autoantibodies were tested. Multivariate logistic regression was performed to compare the associations between different age groups (20 to 34 years old in the low maternal-age group and 35 to 45 years in the advanced maternal-age group) and multiple autoantibodies, while controlling for three confounding factors, including body mass index (BMI), previous history of live birth, and the number of spontaneous abortions. Then, we investigated the differences in the humoral immunity of advanced maternal-age RSA women and low maternal-age RSA women.
UNASSIGNED: A total of 4009 women with RSA were covered in the study. Among them, 1158 women were in the advanced maternal-age group and 2851 women were in the low maternal-age group. The prevalence of antiphospholipid syndrome, systemic lupus erythematosus, Sjogren\'s syndrome, rheumatoid arthritis, and undifferentiated connective tissue disease was 15.6% and 14.1%, 0.0% and 0.1%, 0.9% and 0.9%, 0.3% and 0.0%, and 23.7% and 22.6% in the advanced maternal-age group and low maternal-age group, respectively, showing no statistical difference between the two groups. The positive rates of antiphospholipid antibodies (aPLs), antinuclear antibody (ANA), extractable nuclear antigen (ENA) antibody, anti-double stranded DNA (dsDNA) antibody, anti single-stranded DNA (ssDAN) antibody, antibodies against alpha-fodrin (AAA), and thyroid autoimmunity (TAI) were 19.1% and 19.5%, 6.6% and 6.6%, 9.2% and 10.5%, 2.0% and 2.0%, 2.2% and 1.2%, 5.1% and 4.9%, and 17.8% and 16.8%, respectively. No differences were observed between the two groups. 1.6% of the women in the advanced maternal-age group tested positive for lupus anticoagulant (LA), while 2.7% of the women in the low maternal-age group were LA positive, with the differences being statistically significant (odds ratio=0.36, 95% confidence interval: 0.17-0.78). In the 4008 RSA patients, the cumulative cases tested positive for the three antibodies of the aPLs spectrum were 778, of which 520 cases were positive for anti-β2 glycoprotein Ⅰ antibodies (β2GPⅠ Ab)-IgG/IgM, 58 were positive for aCL-IgG/IgM, 73 were positive for LA, 105 were positive for both β2GPⅠ Ab-IgG/IgM and aCL-IgG/IgM, 17 were positive for both β2GPⅠ Ab-IgG/IgM and LA, 2 were positive for both aCL-IgG/IgM and LA, and 3 were positive for all three antibodies.
UNASSIGNED: Our study did not find a difference in humoral immunity between RSA women of advanced maternal age and those of low maternal age.
UNASSIGNED: A retrospective study was performed between January 2022 and October 2023 in the Department of Reproductive Immunity of Shanghai First Maternity and Infant Hospital. Women with RSA were recruited and multiple autoantibodies were tested. Multivariate logistic regression was performed to compare the associations between different age groups (20 to 34 years old in the low maternal-age group and 35 to 45 years in the advanced maternal-age group) and multiple autoantibodies, while controlling for three confounding factors, including body mass index (BMI), previous history of live birth, and the number of spontaneous abortions. Then, we investigated the differences in the humoral immunity of advanced maternal-age RSA women and low maternal-age RSA women.
UNASSIGNED: A total of 4009 women with RSA were covered in the study. Among them, 1158 women were in the advanced maternal-age group and 2851 women were in the low maternal-age group. The prevalence of antiphospholipid syndrome, systemic lupus erythematosus, Sjogren\'s syndrome, rheumatoid arthritis, and undifferentiated connective tissue disease was 15.6% and 14.1%, 0.0% and 0.1%, 0.9% and 0.9%, 0.3% and 0.0%, and 23.7% and 22.6% in the advanced maternal-age group and low maternal-age group, respectively, showing no statistical difference between the two groups. The positive rates of antiphospholipid antibodies (aPLs), antinuclear antibody (ANA), extractable nuclear antigen (ENA) antibody, anti-double stranded DNA (dsDNA) antibody, anti single-stranded DNA (ssDAN) antibody, antibodies against alpha-fodrin (AAA), and thyroid autoimmunity (TAI) were 19.1% and 19.5%, 6.6% and 6.6%, 9.2% and 10.5%, 2.0% and 2.0%, 2.2% and 1.2%, 5.1% and 4.9%, and 17.8% and 16.8%, respectively. No differences were observed between the two groups. 1.6% of the women in the advanced maternal-age group tested positive for lupus anticoagulant (LA), while 2.7% of the women in the low maternal-age group were LA positive, with the differences being statistically significant (odds ratio=0.36, 95% confidence interval: 0.17-0.78). In the 4008 RSA patients, the cumulative cases tested positive for the three antibodies of the aPLs spectrum were 778, of which 520 cases were positive for anti-β2 glycoprotein Ⅰ antibodies (β2GPⅠ Ab)-IgG/IgM, 58 were positive for aCL-IgG/IgM, 73 were positive for LA, 105 were positive for both β2GPⅠ Ab-IgG/IgM and aCL-IgG/IgM, 17 were positive for both β2GPⅠ Ab-IgG/IgM and LA, 2 were positive for both aCL-IgG/IgM and LA, and 3 were positive for all three antibodies.
UNASSIGNED: Our study did not find a difference in humoral immunity between RSA women of advanced maternal age and those of low maternal age.
摘要：
■确定患有复发性自然流产（RSA）的高龄孕产妇的体液免疫。
■于2022年1月至2023年10月在上海市第一妇婴医院生殖免疫科进行了一项回顾性研究。招募患有RSA的妇女并测试多种自身抗体。多因素logistic回归比较不同年龄组(低龄组20~34岁,高龄组35~45岁)和多种自身抗体之间的关联,在控制三个混杂因素的同时，包括体重指数（BMI），以前的活产史，以及自然流产的数量。然后，我们调查了高龄女性RSA和低龄女性RSA的体液免疫差异.
■本研究涵盖了4009名患有RSA的女性。其中,1158名妇女为高龄产妇组，2851名妇女为低龄产妇组。抗磷脂综合征的患病率，系统性红斑狼疮,干燥综合征,类风湿性关节炎,未分化结缔组织病分别为15.6%和14.1%，0.0%和0.1%，0.9%和0.9%，0.3%和0.0%,高龄组和低龄组分别为23.7%和22.6%,分别,两组间无统计学差异。抗磷脂抗体（aPL）的阳性率，抗核抗体（ANA），可提取核抗原（ENA）抗体，抗双链DNA（dsDNA）抗体，抗单链DNA（ssDAN）抗体，抗α-fodrin（AAA）的抗体，甲状腺自身免疫（TAI）分别为19.1%和19.5%，6.6%和6.6%，9.2%和10.5%，2.0%和2.0%，2.2%和1.2%，5.1%和4.9%，和17.8%和16.8%，分别。两组间无差异。1.6%的高龄孕妇组狼疮抗凝物(LA)检测呈阳性,而低龄组的女性中有2.7％为LA阳性，差异具有统计学意义（比值比=0.36，95％置信区间：0.17-0.78）。在4008例RSA患者中，3种抗体检测阳性的累计病例为778例,其中抗β2糖蛋白Ⅰ抗体(β2GPⅠAb)-IgG/IgM阳性520例,58为aCL-IgG/IgM阳性，73对洛杉矶呈阳性，105例β2GPⅠAb-IgG/IgM和aCL-IgG/IgM阳性，17例β2GPⅠAb-IgG/IgM和LA均为阳性，2对aCL-IgG/IgM和LA均呈阳性，和3对所有三种抗体均为阳性。
■我们的研究没有发现高龄的RSA女性和低龄的RSA女性之间的体液免疫差异。
■于2022年1月至2023年10月在上海市第一妇婴医院生殖免疫科进行了一项回顾性研究。招募患有RSA的妇女并测试多种自身抗体。多因素logistic回归比较不同年龄组(低龄组20~34岁,高龄组35~45岁)和多种自身抗体之间的关联,在控制三个混杂因素的同时，包括体重指数（BMI），以前的活产史，以及自然流产的数量。然后，我们调查了高龄女性RSA和低龄女性RSA的体液免疫差异.
■本研究涵盖了4009名患有RSA的女性。其中,1158名妇女为高龄产妇组，2851名妇女为低龄产妇组。抗磷脂综合征的患病率，系统性红斑狼疮,干燥综合征,类风湿性关节炎,未分化结缔组织病分别为15.6%和14.1%，0.0%和0.1%，0.9%和0.9%，0.3%和0.0%,高龄组和低龄组分别为23.7%和22.6%,分别,两组间无统计学差异。抗磷脂抗体（aPL）的阳性率，抗核抗体（ANA），可提取核抗原（ENA）抗体，抗双链DNA（dsDNA）抗体，抗单链DNA（ssDAN）抗体，抗α-fodrin（AAA）的抗体，甲状腺自身免疫（TAI）分别为19.1%和19.5%，6.6%和6.6%，9.2%和10.5%，2.0%和2.0%，2.2%和1.2%，5.1%和4.9%，和17.8%和16.8%，分别。两组间无差异。1.6%的高龄孕妇组狼疮抗凝物(LA)检测呈阳性,而低龄组的女性中有2.7％为LA阳性，差异具有统计学意义（比值比=0.36，95％置信区间：0.17-0.78）。在4008例RSA患者中，3种抗体检测阳性的累计病例为778例,其中抗β2糖蛋白Ⅰ抗体(β2GPⅠAb)-IgG/IgM阳性520例,58为aCL-IgG/IgM阳性，73对洛杉矶呈阳性，105例β2GPⅠAb-IgG/IgM和aCL-IgG/IgM阳性，17例β2GPⅠAb-IgG/IgM和LA均为阳性，2对aCL-IgG/IgM和LA均呈阳性，和3对所有三种抗体均为阳性。
■我们的研究没有发现高龄的RSA女性和低龄的RSA女性之间的体液免疫差异。
