复发性流产患者妊娠后出现宫颈机能不全情况及相关危险因素分析

Analysis of cervical insufficiency and related risk factors in patients with recurrent abortion after pregnancy

目的分析复发性流产患者妊娠后出现宫颈机能不全情况及相关危险因素。方法回顾性分析2020年5月—2022年11月于浙江萧山医院进行诊治的85例复发性流产患者的临床资料,其中妊娠后出现宫颈机能不全者55例,设为出现宫颈机能不全组,妊娠后未出现宫颈机能不全者30例,设为未出现宫颈机能不全组。对比两组年龄、孕期体质量指数(BMI)、孕周、孕次、辅助生殖受孕、人绒毛膜促性腺激素(hCG)、C-反应蛋白(CRP)、中性粒细胞百分比(NEUT%)、白蛋白(ALB)、可溶性类fms酪氨酸激酶-1(sFl-1)、B族链球菌(GBS)情况;对相关变量进行单因素、多因素logistic回归分析。结果单因素分析显示,两组年龄、孕期BMI、孕周差异无统计学意义(P>0.05);孕周、孕次、辅助生殖受孕、hCG、CRP、NEUT%、ALB、sFlt-1、GBS差异有统计学意义(P<0.05)。多因素logistie回归分析显示,孕4次以上、采取辅助生殖受孕、hCG<150.00 U/ml、CRP≥46.80 mg/L、NEUT%>70%、ALB<35.00 g/L、sFlt-1>10.00 IU/L、GBS阳性是复发性流产患者在妊娠后出现宫颈机能不全的独立危险因素。结论复发性流产患者在妊娠后出现宫颈机能不全主要受孕4次以上、采取辅助生殖受孕、hCG<150.00 U/ml、CRP≥46.80 mg/L、NEUT%>70%、ALB<35.00 g/L、sFlt-1>10.00 IU/L、GBS阳性等影响。

Objective To analyze the cervical insufficiency and related risk factors in patients with recurrent abortion after pregnan-cy.Methods Clinical data of 85 patients with recurrent abortion treated in Xiaoshan Hospital of Zhejiang Province from May 2020 to No-vember 2022 were retrospectively analyzed.Among them,55 patients with cervical insufficiency after pregnancy were set as the present group,and 30 patients without cervical insufficiency after pregnancy were set as the non-present group.Age,gestational body mass index(BMI),gestational weeks,gestational times,assisted reproductive conception,human chorionic gonadotropin(hCG),C-reactive protein(CRP),neutrophil percentage(NEUT%),albumin(ALB),soluble fms tyrosine kinase-1(sFl-1)and Group B streptococcus(GBS)were compared between the two groups.Univariate and multivariate logistic regression analysis was performed for the relevant varia-bles.Results Univariate analysis showed that there was no significant difference in age,gestational BMI and gestational age between the two groups(P>0.05).There were significant differences in gestational age,gestational number,assisted reproduction conception,hCG,CRP,NEUT%,ALB,sFlt-1 and GBS(P<0.05).Multifactor logistie regression analysis showed that More than 4 pregnancies,assisted repro-duction,hCG<150.00 U/ml,CRP≥46.80 mg/L,NEUT%>70%,ALB<35.00 g/L,sFlt-1>10.00 IU/L,GBS Positivity is an independent risk factor for cervical incompetence in patients with recurrent abortion after pregnancy.Conclusion Patients with recurrent abortion had cervical incompetence more than 4 times after pregnancy,assisted reproduction,hCG<150.00 U/ml,CRP≥46.80 mg/L,NEUT%>70%,ALB<35.00 g/L,sFlt-1>10.00 IU/L,GBS Positive and other effects.