夫精人工授精妊娠成功后早期先兆流产的危险因素分析

目的探讨分析夫精人工授精妊娠成功后早期先兆流产的危险因素。方法选取湖北省荆州市中心医院生殖中心2015年2月至2018年7月诊治的122例实施夫精人工授精治疗且妊娠成功的不孕症患者的临床资料作为研究对象。对这122例患者的临床资料作回顾性分析,统计其早期先兆流产的发生率。根据是否发生早期先兆流产分为发生组和未发生组。对比两组患者间可能影响早期先兆流产发生的危险因素的构成比差异,并进行Logistic多元回归分析。结果本组患者中早期先兆流产的发生率为31.15%,发生组患者年龄>35岁者构成比与未发生组患者相近,差异无统计学意义(P>0.05),发生组患者有流产史、盆腔粘连、孕前TORCH阳性、抗心磷脂抗体阳性、宫腔操作日子宫内膜厚度<7mm、伴有严重负性情绪者构成比均高于未发生组患者,差异均具有统计学意义(均P<0.05),安胎中药辅助治疗者构成比明显低于未发生组,差异具有统计学意义(P<0.05);经Logistic回归分析表明,有流产史、盆腔粘连、孕前TORCH阳性、抗心磷脂抗体阳性、宫腔操作日子宫内膜厚度<7mm、伴有严重负性情绪均是夫精人工授精妊娠成功后早期先兆流产的危险因素(OR=3.442、5.726、5.414、5.485、4.730、5.371,均P<0.05),安胎中药辅助治疗是其保护因素(OR=0.511,P<0.05)。结论夫精人工授精妊娠成功后早期先兆流产的发生风险较高,且有流产史、盆腔粘连等均是其独立危险因素,而安胎中药辅助治疗是其保护因素。

Analysis of the risk factors for threatened abortion of women with successful pregnancy after artificial insemination by husband

Objective To explore and analyze the risk factors for threatened abortion of women with successful pregnancy after artificial insemination by husband(AIH).Methods The clinical data of 122 infertile women with successful pregnancy after AIH in our hospital from February 2015 to July 2018 were retrospectively analyzed,and the incidence of early threatened abortion was recorded.The patients were divided into the threatened abortion group and non-threatened abortion group according to whether they had early threatened abortion or not.The risk factors for threatened abortion were compared between the two groups,and Logistic multiple regression analysis was performed.Results The incidence of early threatened abortion was 31.15%among all the patients.The proportion of pregnant women aged over 35 in the threatened abortion group was similar to that in the non-threatened abortion group,without statistically significant differences(P>0.05).The proportions of patients with history of abortion,with pelvic adhesions,with TORCH positive before pregnancy,with anticardiolipin antibody positive,with endometrial thickness<7 mm on the day of uterine cavity operation and severe negative emotions in the threatened abortion group were higher than those in the non-threatened abortion group,with statistically significant differences(all P<0.05),and the proportion of patients having received Chinese medicines assistant treatment was significantly lower than that in the non-threatened abortion group,with statistically significant differences(P<0.05).Logistic regression analysis showed that history of abortion,pelvic adhesions,TORCH positive before pregnancy,anticardiolipin antibody positive,endometrial thickness<7 mm on the day of uterine cavity operation and severe negative emotions were all risk factors for threatened abortion after successful pregnancy with AIH(OR=3.442,5.726,5.414,5.485,4.730,5.371,all P<0.05),while being treated with Chinese medicines assistant treatment was a protective factor(OR=0.511,P<0.05).Conclusions The risk of threatened abortion is high in the early stage after successful pregnancy with AIH,and history of abortion,pelvic adhesions and so on are all independent risk factors,while Chinese medicine assistant treatment is a protective factor.