自身免疫性疾病和亚甲基四氢叶酸还原酶多态性患者在妊娠22周前的单胎妊娠丢失

Q3 Medicine

Human Antibodies Pub Date : 2022-01-01 DOI:10.3233/HAB-211517

Murat Cagan, Ummuhan Okuducu, Hanife Guler Donmez, Mehmet Sinan Beksac

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引用次数: 1

摘要

背景:母体自身免疫性疾病(AD)和亚甲基四氢叶酸还原酶(MTHFR)基因多态性等危险因素增加了妊娠损失(PLs)的发生率。目的:评价AD和MTHFR多态性患者妊娠周前单胎PLs (gw) 22。方法:243例1108例单胎妊娠分为:AD患者33例148例妊娠，MTHFR多态性66例316例妊娠，AD +MTHFR多态性144例644例妊娠。PLs分类为:a)化学妊娠(CP)， b)卵衰症(BO)， c) gw≤10,d) gw11-14, e) gw15-22, f)异位妊娠(EP)， g)滋养层疾病(TD)。产科史比较采用Beksac产科指数(BOI):[活胎数+ (π/10)]/妊娠。结果:AD组、MTHFR组、AD +MTHFR组gw22前的PL率分别为39.2%(58/148)、33.2%(105/316)、36.3%(234/644)，差异有统计学意义(p= 0.421)。AD、MTHFR和AD +MTHFR产前筛查期胎儿损失率(CP + BO + gw≥10胎损+ EP + TD)分别为84.8%、75.9%和77.8% (p= 0.264)。重力≥4与重力小于5的人在BOI上有统计学上显著差异(p< 0.001)。结论:AD和/或MTHFR多态性的单胎妊娠gw22前的PL率为35.8%。在妊娠大于或等于5的患者中，临床发现似乎更复杂。

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Singleton pregnancy losses before gestational week 22 among patients with autoimmune disorders and methylenetetrahydrofolate reductase polymorphisms.

Background: The rates of pregnancy losses (PLs) are increased by maternal risk factors such as autoimmune disorders (AD) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms.

Objective: To evaluate singleton PLs before gestational week (gw) 22 among patients with AD and MTHFR polymorphisms.

Methods: Totally, 1108 singleton pregnancies in 243 women were categorized as: 1) 148 pregnancies in 33 patients with AD, 2) 316 pregnancies in 66 patients with MTHFR polymorphisms, 3) 644 pregnancies in 144 patients with AD +MTHFR polymorphisms. PLs were classified into subgroups: a) Chemical Pregnancy(CP), b) Blighted Ovum(BO), c) gw ⩽ 10, d) gw11-14 e) gw15-22, f) Ectopic Pregnancy(EP), g) Trophoblastic Disease(TD). Obstetric histories were compared using Beksac Obstetrics Index (BOI): [number of living child + (π/10)]/gravida.

Results: PL rates before gw22 were 39.2% (58/148), 33.2% (105/316), and 36.3% (234/644) in AD, MTHFR, and AD +MTHFR groups, respectively (p= 0.421). The rate of Pre-Prenatal Screening Period fetal losses (CP + BO + gw ⩽ 10 fetal losses + EP + TD) were 84.8%, 75.9%, and 77.8% in AD, MTHFR, and AD +MTHFR, respectively (p= 0.264). Gravidity ⩽ 4 versus those with gravidity ⩾ 5 had statistically significant differences in BOI (p< 0.001).

Conclusions: PL rate before gw22 among singleton pregnancies with AD and/or MTHFR polymorphisms was 35.8%. The clinical findings seem to be more complicated in patients with gravidity ⩾ 5.

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来源期刊

Human Antibodies Medicine-Immunology and Allergy

CiteScore

3.50

自引率

0.00%

发文量

期刊介绍： Human Antibodies is an international journal designed to bring together all aspects of human hybridomas and antibody technology under a single, cohesive theme. This includes fundamental research, applied science and clinical applications. Emphasis in the published articles is on antisera, monoclonal antibodies, fusion partners, EBV transformation, transfections, in vitro immunization, defined antigens, tissue reactivity, scale-up production, chimeric antibodies, autoimmunity, natural antibodies/immune response, anti-idiotypes, and hybridomas secreting interesting growth factors. Immunoregulatory molecules, including T cell hybridomas, will also be featured.