背景:本研究的目的是探讨抗磷脂抗体(aPLs)和非标准aPLs(NC-aPLs)与妊娠结局的关系。
方法:我们回顾性分析了1574例至少有一次流产的孕妇,这些孕妇接受了aPLs和NC-aPLs的检测,并比较了它们的临床特征,免疫生物标志物,和妊娠结局。χ2检验或Fisher精确检验比较了所有aPLs阴性患者的妊娠结局,对于NC‑aPL亚型,标准aPL亚型呈阳性。
结果:多因素logistic回归分析表明,aPLs呈阳性(OR=2.216,95%CI1.381-3.558),和阳性NC-aPLs(OR=1.619,95%CI1.245-2.106)与不良结局相关。对于胎儿丢失,阳性样本(OR=2.354,95%CI1.448-3.829),NC-aPLs(OR=1.443,95%CI1.076-1.936)有统计学意义。早产与NC-aPL阳性相关(OR=2.102,95%CI1.452-3.043)。在NC-aPLs阳性组中,多阳性亚组的不良结局发生率(77.8%)高于双阳性亚组(52.3%)和单阳性亚组(37.0%).与单阳性亚组相比,多阳性NC-aPLs亚组的胎儿丢失和早产率也较高(48.1%vs.22.6%的胎儿损失和57.1%的对比早产为16.5%)。
结论:我们的研究结果表明,aPLs和NC-aPLs均与不良妊娠结局的发生率增加有关。与单阳性对照相比,存在多个NC-aPL阳性的患者的不良结局发生率更高.
BACKGROUND: The objective of this
study was to investigate both antiphospholipid antibodies (aPLs) and non-criteria aPLs (NC-aPLs) in relation with pregnancy outcomes.
METHODS: We retrospectively analyzed 1574 pregnant women with experienced at least one miscarriage who were tested for aPLs and NC-aPLs, and compared their clinical characteristics, immune biomarkers, and pregnancy outcomes. The χ2 test or Fisher\'s exact test compared pregnancy outcomes among patients negative for all aPLs, positive for NC‑aPLs subtypes, and positive for criteria aPLs subtypes.
RESULTS: Multivariate logistic regression analysis indicated that positive aPLs (OR = 2.216, 95 % CI 1.381-3.558), and positive NC-aPLs (OR = 1.619, 95 % CI 1.245-2.106) are linked to adverse outcomes. For fetal loss, positive aPLs (OR = 2.354, 95 % CI 1.448-3.829), NC-aPLs (OR = 1.443, 95 % CI 1.076-1.936) were significant. Premature delivery was associated with positive NC-aPLs (OR = 2.102, 95 % CI 1.452-3.043). In the NC-aPLs positive group, the rate of adverse outcomes was higher in the multiple-positive subgroup (77.8 %) compared to the double-positive (52.3 %) and single-positive (37.0 %) subgroups. The rates of fetal loss and premature delivery were also higher in the multiple-positive NC-aPLs subgroup compared to the single-positive subgroup (48.1 % vs. 22.6 % for fetal loss and 57.1 % vs. 16.5 % for premature delivery).
CONCLUSIONS: Our findings suggest that both aPLs and NC-aPLs are associated with an increased incidence of adverse pregnancy outcomes, and patients presenting with multiple NC-aPLs positivity were found to have a higher incidence of adverse outcomes compared to their single-positive counterparts.