复发性流产保胎治疗患者难免流产的影响因素分析

Analysis of Influencing Factors of Inevitable Miscarriage in Patients with Recurrent Spontaneous Abortion Treated with Fetal Protection

目的分析复发性流产(RSA)保胎治疗患者难免流产的影响因素。方法本研究为病例对照研究,收集信阳市人民医院2022年03月至2023年09月收治的40例保胎治疗后难免流产的RSA患者病历资料归入发生组;另收集医院同期收治的40例保胎治疗后未发生流产的RSA患者病历资料归入未发生组。对比两组基线资料、实验室指标,通过单因素和多因素分析探讨影响RSA保胎治疗患者难免流产的因素。结果发生组自然流产次数、白介素-17(IL-17)水平显著高于未发生组;本次妊娠距上次流产时间间隔(简称间隔时间)、调节性T细胞(Treg)水平显著低于未发生组;抑郁占比显著高于未发生组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示自然流产次数多、抑郁、IL-17水平高是RSA保胎治疗患者难免流产发生的危险因素(OR>1,P<0.05);间隔时间长、Treg水平高是RSA保胎治疗患者难免流产发生的保护因素(OR<1,P<0.05)。结论自然流产次数多、抑郁、IL-17水平高是RSA保胎治疗患者难免流产发生的危险因素;间隔时间长、Treg水平高是RSA保胎治疗患者难免流产发生的保护因素,临床可根据上述影响因素提前制定和实施针对性干预措施,以期降低RSA保胎治疗患者难免流产风险,改善妊娠结局。

Objective To analyze the influencing factors of inevitable miscarriage in patients with recurrent spontaneous abortion(RSA)undergoing fetal protection treatment.Methods This study was a case-control study,collecting medical records of 40 RSA patients who were admitted to Xinyang People's Hospital from March 2022 to September 2023 and had inevitable miscarriage after prenatal care treatment,and categorizing them into the occurrence group.Medical records of 40 RSA patients who did not experience miscarriage after prenatal care treatment were collected and admitted to the hospital at the same time,and divided into the non occurrence group.The baseline data and laboratory indicators of the two groups were compared,and the factors affecting the inevitable abortion of patients with RSA tocolysis were explored through single factor and multi-factor analysis.Results The number of spontaneous abortions and the level of interleukin-17(IL-17)in the occurrence group were significantly higher than those in the non occurrence group.The interval between this pregnancy and the last miscarriage(referred to as the interval time)and the level of regulatory T cells(Treg)were significantly lower than those in the non occurrence group.The proportion of depression was significantly higher than that of the non occurrence group,with a statistical significant difference(P<0.05).The results of Logistic regression analysis showed that frequent spontaneous abortions,depression,and high levels of IL-17 were risk factors for inevitable miscarriage in RSA abortion treatment patients(OR>1,P<0.05).Long interval time and high Treg levels were protective factors for the inevitable occurrence of miscarriage in RSA abortion treatment patients(OR<1,P<0.05).Conclusions The frequent occurrence of spontaneous miscarriage,depression,and high IL-17 levels are risk factors for inevitable miscarriage in patients undergoing RSA fetal protection treatment.Long intervals and high Treg levels are protective factors for the inevitable occurrence of miscarriage in RSA abortion treatment patients.Clinical interventions can be developed and implemented in advance based on these influencing factors to reduce the risk of inevitable miscarriage in RSA abortion treatment patients and improve pregnancy outcomes.