Abstract：
OBJECTIVE: Short inter-pregnancy interval (IPI) of <18 months following a live birth, has been associated with adverse pregnancy outcome. This study aimed to evaluate whether a short IPI following a medically treated missed abortion (MA) poses similar perinatal risks in a subsequent pregnancy.
METHODS: The retrospective analysis included patients with history of an MA at up to 10 weeks of gestation, treated with misoprostol (pgE1) only, and with a documented subsequent live pregnancy (2010-2022). 1110 Patients were allocated into two groups: IPI ≤18 months and IPI >18 months. The primary outcome was the risk for a spontaneous preterm birth (PTB) <37 weeks of gestation in the consecutive pregnancy. Secondary outcomes included maternal and neonatal adverse outcomes. Statistical analysis was performed using the Statistical Program for Social Sciences for Windows version 26 (SPSS Inc, Chicago, IL).
RESULTS: The cohort included 1,110 patients: 430 (38.74 %) patients with IPI <18 months and 680 (61.26 %) patients with IPI >18 months. The characteristics of the two groups were not significantly different. The rates of spontaneous PTB <37 and <34 weeks of gestation were significantly higher in the short vs. long IPI cohort (16.28 % vs. 7.06 % and 6.74 % vs. 5.0 %, respectively, p < 0.05). These patients also had a higher risk for Cesarean delivery (31.63 % vs. 23.34 %, p = 0.005) and postpartum hemorrhage (4.42 % vs. 2.06 %, p = 0.029) compared to patients with IPI >18 months. The observed differences remained statistically significant even after adjusting for potential confounding variables using multiple regression analysis. No other significant differences in neonatal or maternal outcomes were noted.
CONCLUSIONS: Short IPI (≤18 months) following a medical treatment MA may be associated with an increased risk of PTB, Cesarean delivery and PPH.
METHODS: The retrospective analysis included patients with history of an MA at up to 10 weeks of gestation, treated with misoprostol (pgE1) only, and with a documented subsequent live pregnancy (2010-2022). 1110 Patients were allocated into two groups: IPI ≤18 months and IPI >18 months. The primary outcome was the risk for a spontaneous preterm birth (PTB) <37 weeks of gestation in the consecutive pregnancy. Secondary outcomes included maternal and neonatal adverse outcomes. Statistical analysis was performed using the Statistical Program for Social Sciences for Windows version 26 (SPSS Inc, Chicago, IL).
RESULTS: The cohort included 1,110 patients: 430 (38.74 %) patients with IPI <18 months and 680 (61.26 %) patients with IPI >18 months. The characteristics of the two groups were not significantly different. The rates of spontaneous PTB <37 and <34 weeks of gestation were significantly higher in the short vs. long IPI cohort (16.28 % vs. 7.06 % and 6.74 % vs. 5.0 %, respectively, p < 0.05). These patients also had a higher risk for Cesarean delivery (31.63 % vs. 23.34 %, p = 0.005) and postpartum hemorrhage (4.42 % vs. 2.06 %, p = 0.029) compared to patients with IPI >18 months. The observed differences remained statistically significant even after adjusting for potential confounding variables using multiple regression analysis. No other significant differences in neonatal or maternal outcomes were noted.
CONCLUSIONS: Short IPI (≤18 months) following a medical treatment MA may be associated with an increased risk of PTB, Cesarean delivery and PPH.
摘要：
目标：活产后<18个月的短妊娠间隔（IPI），与不良妊娠结局有关。这项研究旨在评估经过药物治疗的稽留流产（MA）后的短IPI在随后的妊娠中是否会造成类似的围产期风险。
方法：回顾性分析包括妊娠10周有MA病史的患者，仅用米索前列醇（pgE1）治疗，并记录了随后的活胎（2010-2022）。1110例患者被分为两组：IPI≤18个月和IPI>18个月。主要结果是连续妊娠中自发性早产（PTB）<37周的风险。次要结局包括产妇和新生儿的不良结局。使用Windows26版社会科学统计程序（SPSSInc，芝加哥,IL).
结果：该队列包括1,110例患者：430例（38.74％）IPI<18个月患者和680例（61.26％）IPI>18个月患者。两组特点无明显差别。妊娠期自发性PTB<37周和<34周的发生率明显高于对照组。长IPI队列（16.28%与7.06%和6.74%与5.0%，分别,p<0.05)。这些患者剖腹产的风险也较高(31.63%vs.23.34%,p=0.005）和产后出血（4.42%vs.2.06%,p=0.029）与IPI>18个月的患者相比。即使在使用多元回归分析调整潜在的混杂变量后，观察到的差异仍具有统计学意义。没有发现新生儿或产妇结局的其他显着差异。
结论：医学治疗MA后的短IPI（≤18个月）可能与PTB风险增加有关，剖宫产和PPH。
方法：回顾性分析包括妊娠10周有MA病史的患者，仅用米索前列醇（pgE1）治疗，并记录了随后的活胎（2010-2022）。1110例患者被分为两组：IPI≤18个月和IPI>18个月。主要结果是连续妊娠中自发性早产（PTB）<37周的风险。次要结局包括产妇和新生儿的不良结局。使用Windows26版社会科学统计程序（SPSSInc，芝加哥,IL).
结果：该队列包括1,110例患者：430例（38.74％）IPI<18个月患者和680例（61.26％）IPI>18个月患者。两组特点无明显差别。妊娠期自发性PTB<37周和<34周的发生率明显高于对照组。长IPI队列（16.28%与7.06%和6.74%与5.0%，分别,p<0.05)。这些患者剖腹产的风险也较高(31.63%vs.23.34%,p=0.005）和产后出血（4.42%vs.2.06%,p=0.029）与IPI>18个月的患者相比。即使在使用多元回归分析调整潜在的混杂变量后，观察到的差异仍具有统计学意义。没有发现新生儿或产妇结局的其他显着差异。
结论：医学治疗MA后的短IPI（≤18个月）可能与PTB风险增加有关，剖宫产和PPH。
