摘要
目的探讨孕早期血清同型半胱氨酸(homocysteine,HCY)及叶酸水平与原因不明自然流产的关系。方法分析2013年1月至2014年1月深圳市妇幼保健院接受常规孕检的1 315例孕早期(孕周≤10周)孕妇的临床资料,按是否出现原因不明自然流产,将孕妇分为观察组(82例)和对照组(1 233例),采用单因素分析及多因素Logistic回归分析原因不明自然流产危险因素;以对照组血清HCY及叶酸水平的第10或90百分位数为界值,比较不同水平组原因不明自然流产的发病风险。结果年龄、孕次、自然流产史、孕前低体重、高HCY血症(OR=2.667,P<0.05)为原因不明自然流产危险因素,围孕期服用叶酸、高血清叶酸水平(OR=0.228,P<0.05)为其保护因素。血清叶酸低水平或血清高HCY水平的孕妇,其原因不明自然流产危险性均高于相关指标正常孕妇(OR=2.4、1.7,P<0.05)。结论孕早期高血清HCY、低血清叶酸水平均可能导致原因不明自然流产发生危险增加,联合检测两项指标可能有助于识别高危孕妇。
Objective To discuss the relationship between early pregnancy serum homocysteine（ HCY） level and serum folic acid level with unexplained spontaneous abortion. Methods Data of 1 315 cases of early pregnant women（ gestational age ≤ 10weeks） accepted routine examination in Maternal and Child Health Hospital of Shenzhen City from Jan 2013 to Jan 2014 were analyzed.All cases were divided into observation group（ n = 82） and control group（ n = 1 233） according to whether unexplained spontaneous abortion occurred. The risk factors of unexplained spontaneous abortion were analyzed with univariate analysis and logistic regression analysis,using 10 th or 90 th percentile serum HCY and folic acid levels of control group as boundary values,risk of unexplained spontaneous abortion of different level groups were compared. Results Age,gravidity,history of spontaneous abortion,and low weight before pregnancy,high HCY,hyperlipidemia（ OR = 2. 667,P 0. 05） were risk factors of spontaneous abortion,taking folic acid during pregnancy,high serum folic acid level（ OR = 0. 228,P〈0. 05） were protective factors. The risk of spontaneous abortion for pregnant women with low level of serum folic acid or high level of serum HCY was higher than pregnant women with normal level（ OR = 2. 4,1. 7,P〈0. 05）. Conclusion High level of serum HCY and low level of serum folic acid in early pregnancy may result in increasing the risk of unexplained spontaneous abortion,combined detection of two indexes may help to identify high- risk pregnant women.
出处
《中国计划生育和妇产科》
2015年第3期27-30,共4页
Chinese Journal of Family Planning & Gynecotokology
基金
2013年深圳市医疗卫生类科研项目(项目编号:201303071)
关键词
孕早期
同型半胱氨酸
叶酸
原因不明自然流产
early pregnancy
homocysteine
folic acid
unexplained spontaneous abortion
