■本研究旨在评估抗磷脂抗体(aPL)阳性双胎妊娠的影响,这是一种罕见而复杂的临床疾病,对管理来说仍然是一个巨大的挑战。
这项研究在2018年1月至2023年8月期间在我们医院招募了双胎孕妇。使用倾向评分匹配(PSM)选择有和没有aPL阳性的女性。在PSM队列中比较两组的临床特征和妊娠结局。分析aPL阳性对妊娠结局的影响,多变量逻辑模型用于获得具有95%置信区间(CI)的校正比值比(aOR).
■在773名双胎孕妇中,26名女性(3.36%)发现aPL阳性。在PSM队列中,有24名双胎孕妇aPL阳性,选择48例无aPL的女性作为对照。aPL阳性的双胎孕妇流产比例较高(8.33%vs0,P=0.043),早产<34周(33.33%vs8.33%,P=0.007)和非常低的出生体重(<1500g)(20.83%vs4.17%,P=0.016)比对照组。此外,在一名aPL阳性的双胎孕妇中观察到一个胎儿的死产。多因素logistic回归分析显示双胎妊娠aPL阳性与早产<34周相关(aOR=2.76,95%CI:0.83~4.70,P=0.005)。极低出生体重(<1500g)(OR=2.40,95%CI:0.18-4.67,P=0.034)和小于胎龄儿(SGA)(aOR=1.66,95%CI:0.22-3.10,P=0.024)。
■具有aPL阳性的双胎妊娠与产科并发症相关,包括堕胎,早产<34周和非常低的出生体重(<1500克)。aPL的检测可能对双胎妊娠妇女具有临床意义,应在未来的研究中予以考虑。
UNASSIGNED: This study aimed to evaluate the impact of twin pregnancies with antiphospholipid antibody (aPL) positivity, a rare and complex clinical condition that remains a huge challenge for management.
UNASSIGNED: This study enrolled twin-pregnant women at our hospital between January 2018 and August 2023. Women with and without aPL positivity were selected using propensity score matching (PSM). Clinical features and pregnancy outcomes were compared between the two groups in the PSM cohort. To analyze the effect of aPL positivity on pregnancy outcomes, multivariate logistic models were used to obtain adjusted odds ratios (aOR) with 95% confidence intervals (CI).
UNASSIGNED: Among the 773 women with twin pregnancies, aPL positivity was found in 26 women (3.36%). In the PSM cohort, there were 24 twin-pregnant women with positive aPL, and 48 women without aPL were selected as controls. Twin-pregnant women with aPL positivity had a higher proportion of abortion (8.33% vs 0, P = 0.043), preterm birth < 34 weeks (33.33% vs 8.33%, P = 0.007) and very low birthweight (<1500 g) (20.83% vs 4.17%, P = 0.016) than the control group. In addition, stillbirth of one fetus was observed in one twin-pregnant woman with positive aPL. Multivariate logistic regression analysis revealed that twin pregnancy with aPL positivity was associated with preterm birth < 34 weeks (aOR = 2.76, 95% CI: 0.83-4.70, P = 0.005), very low birthweight (<1500 g) (OR = 2.40, 95% CI: 0.18-4.67, P = 0.034) and small for gestational age (SGA) (aOR = 1.66, 95% CI: 0.22-3.10, P =0.024).
UNASSIGNED: Twin pregnancies with aPL positivity were correlated with obstetric complications, including abortion, preterm birth < 34 weeks and very low birthweight (<1500 g). The detection of aPL may be of clinical significance for women with twin pregnancies and should be considered in future studies.