Karyotype of first clinical miscarriage and prognosis of subsequent pregnancy outcome.
Karyotype of first clinical miscarriage and prognosis of subsequent pregnancy outcome.
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DOI：
10.1016/j.rbmo.2021.03.021
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发表时间：
2021-06
影响因子：
4
通讯作者：
Lathi RB
中科院分区：
文献类型：
--
作者：
Murugappan G;Leonard SA;Newman H;Shahine L;Lathi RB
不孕症患者首次临床流产(CM)的核型是否预示着后续妊娠的结局？对不育患者进行了回顾性队列研究，这些患者在第一次(指数)CM时接受了手工真空抽吸和染色体检测，并被诊断为基因诊断，并随后怀孕。纳入了1999-2018年间在两个学术附属生育中心接受治疗的患者。使用植入前基因检测进行非整倍体检查的患者被排除在外。主要结局是下一次怀孕时的活产。指标妊娠组包括100例整倍体CM和151例非整倍体CM。指数妊娠中的整倍体CM患者在随后的妊娠中的活产率为63%，而非整倍体CM患者的活产率为68%(AOR为0.75，CI为0.47-1.39，p=0.45，Logistic回归模型调整了年龄、胎次、BMI和受孕方式)。在具有三种结局(LB、CM或生化流产(BM))的多项Logistic回归模型中，与非整倍体CM相比，指标妊娠的整倍体CM与非整倍体CM在后续妊娠中发生CM的几率相似(分别为32%对24%，AOR 1.49，CI 0.83-2.70，p=0.19)。与非整倍体CM相比，指标妊娠的整倍体CM与后续妊娠发生BM的可能性无关(AOR分别为5%和8%，CI为0.14-1.55，p=0.21)。在不孕症患者中，第一次CM后的预后在整倍体和非整倍体核型患者中是同样有利的，并且与妊娠丢失的核型无关。
Is the karyotype of the first clinical miscarriage (CM) in an infertile patient predictive of the outcome of the subsequent pregnancy? Retrospective cohort study of infertile patients undergoing manual vacuum aspiration with chromosome testing at the time of the first (index) CM with a genetic diagnosis and a subsequent pregnancy. Patients treated at two academic-affiliated fertility centers from 1999–2018 were included. Patients utilizing preimplantation genetic testing for aneuploidy were excluded. Main outcome was live birth in the subsequent pregnancy. 100 patients with euploid CM and 151 patients with aneuploid CM in the index pregnancy were included. Patients with euploid CM in the index pregnancy had a live birth (LB) rate of 63% in the subsequent pregnancy compared to 68% among patients with aneuploid CM (aOR 0.75, CI .47–1.39, p=0.45, logistic regression model adjusting for age, parity, BMI, and mode of conception). In a multinomial logistic regression model with three outcomes (LB, CM, or biochemical miscarriage (BM)), euploid CM for the index pregnancy was associated with similar odds of CM in the subsequent pregnancy compared to aneuploid CM for the index pregnancy (32% vs 24%, respectively, aOR 1.49, CI 0.83–2.70, p=0.19). Euploid CM for the index pregnancy was not associated with likelihood of BM in the subsequent pregnancy compared to aneuploid CM (5% vs 8%, respectively, aOR 0.46, CI 0.14–1.55, p=0.21). Prognosis after a first CM among infertile patients is equally favorable among patients with euploid and aneuploid karyotype, and independent of the karyotype of the pregnancy loss.
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DOI：
10.1002/tera.1420120103
发表时间：
1975-01-01
期刊：
TERATOLOGY
影响因子：
--
作者：
BOUE, J;BOUE, A;LAZAR, P
通讯作者：
LAZAR, P
DOI：
10.1016/0002-9378(95)90616-9
发表时间：
1995-11-01
影响因子：
9.8
作者：
WOLF, GC;HORGER, EO
通讯作者：
HORGER, EO
影响因子：
5.3
作者：
HASSOLD, T;CHIU, D
通讯作者：
CHIU, D
影响因子：
6.7
作者：
Ogasawara, M;Aoki, K;Suzumori, K
通讯作者：
Suzumori, K
影响因子：
3.4
作者：
Klock, SC;Chang, G;Hill, J
通讯作者：
Hill, J