目的:评估复发性流产(RM)妇女抗膜联蛋白A5抗体(aAnxA5)中位数倍数(MOM)与随后的妊娠结局之间的相关性。
方法:完全,本研究包括310名RM妇女,并根据其通过ELISA确定的孕前aAnxA5循环水平的MOM分组。采用多因素logistic回归分析aAnxA5对妊娠结局的影响。结果包括早期流产(妊娠10周前),晚期流产(10至24周),持续怀孕(超过10周),和活产(24周后),其特征是怀孕并有胎儿心跳。
结果:对于aAnxA5MOM的每增加一个单位,24周后活产和持续妊娠的几率降低了40.2%(OR=.598;95CI0.406-0.882,P=.010)和38.1%(OR=.619;95CI0.424-0.904,P=.013),分别,在调整人口统计学和临床特征后。aAnxA5MOM的升高与早期流产(OR=1.616;95CI1.106-2.361,P=0.013)和流产(早期+晚期流产)(OR=1.671;95CI1.134-2.464,P=.010)的风险增加相关。进一步的亚组分析显示,在两个亚组中,妊娠24周后活产率的风险降低:产妇年龄≥35岁(OR=0.131;95CI0.026-0.652),既往妊娠丢失≥3(OR=.381;95CI0.173-0.837)。
结论:RM女性的孕前aAnxA5MOM水平较高可能与24周后活产风险降低和早期流产风险增加有关。尤其是年龄≥35岁或既往妊娠损失≥3岁的个体。
OBJECTIVE: To evaluate the correlation between the antiannexin A5 antibodies (aAnxA5) multiples of median (MOM) and subsequent pregnancy outcomes in women with recurrent miscarriage (RM).
METHODS: Totally, 310 RM women were included in this study and grouped into tertiles according to their MOM of preconception aAnxA5 circulating levels determined by ELISA. The effect of aAnxA5 on the pregnancy outcomes was performed using multiple logistic regression. The outcomes included early miscarriage (before 10 weeks of gestation), late miscarriage (between 10 and 24 weeks), ongoing pregnancy (beyond 10 weeks), and live birth (after 24 weeks) characterized by pregnancy with fetal heartbeat.
RESULTS: For each unit increase in aAnxA5 MOM, the odds of live birth after 24 weeks and ongoing pregnancy were reduced by 40.2% (OR = .598; 95%CI 0.406-0.882, P = .010) and 38.1% (OR = .619; 95%CI 0.424-0.904, P = .013), respectively, after adjusting for demographic and clinical characteristics. The rise in aAnxA5 MOM was associated with an increased risk of early miscarriage (OR = 1.616; 95%CI 1.106-2.361, P = .013) and miscarriage (early + late miscarriage) (OR = 1.671; 95%CI 1.134-2.464, P = .010). Further subgroup analyses showed a decreased risk of live birth rates after 24 weeks of gestation in the two subgroups: maternal age ≥35 years (OR = .131; 95%CI 0.026-0.652), and previous pregnancy loss ≥ 3 (OR = .381; 95%CI 0.173-0.837).
CONCLUSIONS: Higher preconception aAnxA5 MOM levels in women with RM may be linked with a decreased risk of live birth after 24 weeks and an increased risk of early miscarriage, especially in individuals aged ≥35 years or with previous pregnancy losses ≥3.