宫颈机能不全的高危因素及发病机制

High Risk Factors and Pathogenesis of Cervical Incompetence

宫颈机能不全(cervical incompetence,CIC)是一种由于宫颈承托力降低所致的疾病,其可导致复发性流产或早产,增加新生儿不良结局发生率。但目前对于CIC的病因学研究尚不明确,尚无较好的识别与预测方法。先天性或获得性宫颈发育不全、体质量指数、雄激素、抗苗勒管激素和松弛素等内分泌激素以及体外受精-胚胎移植均为CIC的危险因素。导致CIC的原因可能为影响免疫炎症或胶原蛋白合成相关基因突变、内分泌激素对宫颈的重塑作用。目前对于CIC的预测尚无较好的手段,有研究通过超声测量宫颈弹性实现对CIC的预测,也有研究建立CIC的预测模型,但是预测价值均有限。通过对CIC病因学方面的研究进行综述,以期为后续研究提供方向。

Cervical incompetence(CIC)is a disease caused by reduced cervical support,which can lead to recurrent miscarriage or premature birth,increasing the incidence of adverse outcomes in newborns.However,the etiology of CIC is currently unclear and there is no reliable method for identification and prediction.Risk factors for CIC include congenital or acquired cervical hypoplasia,body mass index(BMI),androgens level,anti-Müllerian hormone(AMH),relaxin and other endocrine hormones,as well as in vitro fertilization-embryo transfer(IVF-ET).The cause of CIC may involve gene mutations related to immune inflammation or collagen synthesis,as well as the role of endocrine hormones in cervical remodeling.At present,there is no good method for predicting CIC.There are some studies using ultrasound to measure cervical elasticity to achieve CIC prediction,and there are also studies establishing CIC prediction models,but their predictive value is limited.By reviewing research on the etiology of CIC,we aim to provide direction for future research.