复发性流产女性再次妊娠产科结局分析OACSTPCD

Objective:To explore the impact of a history of recurrent spontaneous abor-tion(RSA)on the occurrence of pregnancy complications and obstetric outcomes in a subse-quent pregnancy.Methods:217 parturients with a history of RSA(RSA group)and 434 parturi-ents without a history of RSA(control group)who have given birth at the Second Affiliated Hos-pital of Zhengzhou University from January 2021 to December 2022 were selected.The RSA group was divided into primary RSA group and secondary RSA group based on whether there had been a history of live labor in the past and divided into different RSA subgroups according to the type of last spontaneous abortion and the time of abortion occurrence then pregnancy complications and obstetric outcomes among each group were analyzed.Results:The gestational delivery age in the RSA group(33.43±4.30 years old)was significantly higher than that of the control group(31.71±4.13 years old),and the difference was statistically significant(P<0.05).Univariate analysis showed that the incidence of hypertensive disorders of pregnancy,preeclampsia(PE),preterm premature rupture of membranes(PPROM),oligohydramnios,and assisted reproductive technology(ART)in the RSA group was higher than that in the control group,and the newborn weight and 1-minute Apgar score were lower than those in the control group,and the differences were statistically significant(P<0.05).Multivariate logistic regres-sion showed that RSA was an independent risk factor for oligohydramnios(OR=3.673,95%CI:1.797～7.505)and premature birth(OR=2.542,95%CI:1.393～4.639).The incidence of premature birth(32.3%)in the late miscarriage group was higher than that in the biochemical pregnancy group(9.0%,P=0.005)and early miscarriage group(10.3%,P=0.004).The risk of PPROM,premature birth,and low birth weight infants(LBW)in those with more than two miscarriages was higher than in those with two miscarriages(P<0.05).The risk of oligo-hydramnios and ART conception in the primary RSA group was higher than that in the seconda-ry RSA group(P<0.05)and the 1-minute Apgar score of newborns was lower than that in the secondary RSA group(P<0.05).There was no significant difference in pregnancy complica-tions between patients who received low molecular weight heparin(LMWH),hydroxychloro-quine or aspirin during pregnancy and those who did not received medication(P<0.05).Con-clusions:The age of re-birth in RSA women is significantly delayed,and there are significant high-risk factors for pregnancy complications.The risk of pregnancy complications and adverse obstetric outcomes increases in subsequent pregnancy.RSA medical history is an independent risk factor for preterm birth and oligohydramnios.More than two miscarriages,late miscarriages,and primary RSA have more prominent adverse obstetric outcomes.Therefore attention should be paid to perinatal care and pregnancy management for RSA patients.