Abstract：
OBJECTIVE: To study whether gynecologic or reproductive disorders show association with trisomic conceptions.
METHODS: This nationwide cohort study utilized the Registry of Congenital Malformations to identify women who had a trisomic pregnancy (n = 5784), either with trisomy 13 (T13; n = 351), trisomy 18 (T18; n = 1065) or trisomy 21 (T21; n = 4369) from 1987 to 2018. We used the Finnish Maternity cohort to match the cases to population controls (n = 34 422) on the age, residence, and timing of pregnancy. These data were cross-linked to the ICD-10 diagnoses of the national Care Registry for Health Care data on specialized health care in Finland during 1996 to 2019. Both inflammatory (ICD-10 diagnoses: N70-N77) and noninflammatory disorders of the genital tract (N80-N98) were studied. Crude odds ratios (ORs) with 95% CIs were calculated for associations between diagnoses and trisomic conceptions.
RESULTS: The diagnosis of female infertility (N97) at any time was associated with trisomic conceptions (OR: 1.19, 95% CI: 1.08-1.32). In the subgroup analysis, this association was found for T18 (OR: 1.29, 95% CI: 1.03-1.61) and T21 (OR: 1.17, 95% CI: 1.04-1.32), but not for T13 (OR: 1.15, 95% CI: 0.75-1.72). When restricting the timing of the diagnosis of female infertility, an elevated OR was found only after the index pregnancy (OR: 1.81, 95% CI: 1.56-2.09). These increased odds for infertility after trisomic conceptions were observed both in women <35 years (T18 OR: 1.91, 95% CI: 1.21-3.00; T21 OR: 1.68, 95% CI: 1.31-2.14) and in women ≥35 years (T18 OR: 2.17, 95% CI: 1.40-3.33; T21 OR: 1.87; 95% CI: 1.47-2.39), but not after T13 conceptions.
CONCLUSIONS: Our observational data suggest a link between trisomic conceptions and subsequent diagnoses of infertility but do not demonstrate causality. These data implicate that partially similar mechanisms might predispose to trisomy and infertility, regardless of maternal age.
METHODS: This nationwide cohort study utilized the Registry of Congenital Malformations to identify women who had a trisomic pregnancy (n = 5784), either with trisomy 13 (T13; n = 351), trisomy 18 (T18; n = 1065) or trisomy 21 (T21; n = 4369) from 1987 to 2018. We used the Finnish Maternity cohort to match the cases to population controls (n = 34 422) on the age, residence, and timing of pregnancy. These data were cross-linked to the ICD-10 diagnoses of the national Care Registry for Health Care data on specialized health care in Finland during 1996 to 2019. Both inflammatory (ICD-10 diagnoses: N70-N77) and noninflammatory disorders of the genital tract (N80-N98) were studied. Crude odds ratios (ORs) with 95% CIs were calculated for associations between diagnoses and trisomic conceptions.
RESULTS: The diagnosis of female infertility (N97) at any time was associated with trisomic conceptions (OR: 1.19, 95% CI: 1.08-1.32). In the subgroup analysis, this association was found for T18 (OR: 1.29, 95% CI: 1.03-1.61) and T21 (OR: 1.17, 95% CI: 1.04-1.32), but not for T13 (OR: 1.15, 95% CI: 0.75-1.72). When restricting the timing of the diagnosis of female infertility, an elevated OR was found only after the index pregnancy (OR: 1.81, 95% CI: 1.56-2.09). These increased odds for infertility after trisomic conceptions were observed both in women <35 years (T18 OR: 1.91, 95% CI: 1.21-3.00; T21 OR: 1.68, 95% CI: 1.31-2.14) and in women ≥35 years (T18 OR: 2.17, 95% CI: 1.40-3.33; T21 OR: 1.87; 95% CI: 1.47-2.39), but not after T13 conceptions.
CONCLUSIONS: Our observational data suggest a link between trisomic conceptions and subsequent diagnoses of infertility but do not demonstrate causality. These data implicate that partially similar mechanisms might predispose to trisomy and infertility, regardless of maternal age.
摘要：
目的：研究妇科或生殖疾病是否与三体概念有关。
方法：这项全国性的队列研究利用先天性畸形注册来确定三体妊娠的女性（n=5784），具有13三体（T13；n=351），从1987年到2018年，18三体（T18;n=1065）或21三体（T21;n=4369）。我们使用芬兰产妇队列将病例与年龄的人口对照（n=34422）进行匹配，residence,和怀孕的时间。这些数据与1996年至2019年芬兰国家保健登记机构医疗保健数据的ICD-10诊断相关。研究了生殖道的炎症性疾病（ICD-10诊断：N70-N77）和非炎症性疾病（N80-N98）。计算诊断与三体概念之间的关联与95％CI的粗比值比（OR）。
结果：女性不孕症（N97）的诊断与三体概念有关（OR：1.19，95％CI：1.08-1.32）。在亚组分析中，T18（OR：1.29，95%CI：1.03-1.61）和T21（OR：1.17，95%CI：1.04-1.32），但不是T13（OR：1.15，95%CI：0.75-1.72）。当限制女性不孕症的诊断时机时，仅在指征妊娠后发现OR升高(OR:1.81,95%CI:1.56-2.09).在<35岁的女性（T18OR：1.91，95％CI：1.21-3.00;T21OR：1.68，95％CI：1.31-2.14）和≥35岁的女性（T18OR：2.17，95％CI：1.40-3.33;T21OR：1.87;95％CI：1.47-2.39）中，但不是在T13概念之后。
结论：我们的观察数据表明三体概念与随后的不孕症诊断之间存在联系，但没有证明因果关系。这些数据暗示，部分相似的机制可能会导致三体和不孕症，不管母亲的年龄。
方法：这项全国性的队列研究利用先天性畸形注册来确定三体妊娠的女性（n=5784），具有13三体（T13；n=351），从1987年到2018年，18三体（T18;n=1065）或21三体（T21;n=4369）。我们使用芬兰产妇队列将病例与年龄的人口对照（n=34422）进行匹配，residence,和怀孕的时间。这些数据与1996年至2019年芬兰国家保健登记机构医疗保健数据的ICD-10诊断相关。研究了生殖道的炎症性疾病（ICD-10诊断：N70-N77）和非炎症性疾病（N80-N98）。计算诊断与三体概念之间的关联与95％CI的粗比值比（OR）。
结果：女性不孕症（N97）的诊断与三体概念有关（OR：1.19，95％CI：1.08-1.32）。在亚组分析中，T18（OR：1.29，95%CI：1.03-1.61）和T21（OR：1.17，95%CI：1.04-1.32），但不是T13（OR：1.15，95%CI：0.75-1.72）。当限制女性不孕症的诊断时机时，仅在指征妊娠后发现OR升高(OR:1.81,95%CI:1.56-2.09).在<35岁的女性（T18OR：1.91，95％CI：1.21-3.00;T21OR：1.68，95％CI：1.31-2.14）和≥35岁的女性（T18OR：2.17，95％CI：1.40-3.33;T21OR：1.87;95％CI：1.47-2.39）中，但不是在T13概念之后。
结论：我们的观察数据表明三体概念与随后的不孕症诊断之间存在联系，但没有证明因果关系。这些数据暗示，部分相似的机制可能会导致三体和不孕症，不管母亲的年龄。
