Analysis Of Risk Factors Of Embryonic Chromosome Abnormalities And Related Factors In Early Spontaneous Abortion

Objective:To analyze the clinical data,biochemical indexes and distribution characteristics of patients with embryonic chromosome abnormalities with early spontaneous abortion,and to explore the risk factors that may cause embryonic chromosomal abnormalities.Methods:315 patients with early spontaneous abortion and consent for villous chromosome testing were selected.According to the result of the chromosomes of villi tissue microarray analysis（CMA）,315 patients were divided into abnormal group（165 cases）and normal group（150 cases）.The clinical data and biochemical indexes of the two groups were analyzed and compared.The screened variables with statistically significant differences were analyzed by multiple Logistic regression.Result:（1）The rate of chromosome abnormality in early pregnancy spontaneous abortion embryos was 52.38%.Aneuploid,polyploid,and chromosome structural abnormalities accounted for 71.52%,8.48%and 20.00%,respectively.（2）Compared the abnormal group with the normal group,There was no statistically significant differences in the distribution of the male age,female nationality,education,career,life history,birth history and previous medical history（P>0.05）.（3）Compared the abnormal group with the normal group,there was no significant difference in the levels of male age（P>0.05）.（4）There was no statistically significant differences between the two groups in the levels of body mass index（BMI）,serum antinuclear antibodies（ANA）,anticardiolipin antibody（ACA）,antithyroid peroxidase antibody（TPOAb）,antithyroglobulin antibody（TgAb）,fasting insulin（FINS）,fasting blood sugar（FPG）,homocysteine（HCY）,and sex hormone（P>0.05）.（5）Compared the abnormal group with the normal group,there were statistical significance differences of female age,method of conception,serum 25-（OH）D and thyroid stimulating hormone（TSH）（P<0.05）.（6）There was a significant negative correlation between serum 25-（OH）D and TSH（r=-0.030,P<0.05）]in patients with early spontaneous abortion.（7）Multivariate analysis showed that female advanced age and vitamin D deficiency were risk factors for fetal chromosomal abnormalities.Conclusions:（1）The main cause of early spontaneous abortion is embryonic chromosome abnormality,among which aneuploidy is the most common.（2）Embryonic chromosome abnormalities are related to female age,method of conception,levels of serum 25-（OH）D and TSH.（3）Female advanced age and vitamin D deficiency may increase the risk of embryonic chromosome abnormalities.Objective:To detect the iodine nutrition status of patients with recurrent pregnancy loss（RPL）before pregnancy and in early pregnancy,and to analyze the clinical data and thyroid related indexes of RPL patients in different iodine nutrition groups.To explore the correlation between different pregnancy outcomes and iodine nutrition and thyroid indicators,and provide some guidance for iodine intake and iodine supplement in RPL patients.Methods:（1）A total of 292 RPL patients（case group）were selected for urine iodine concentration（UIC）detection.They were divided into iodine deficiency group,iodine moderate group and iodine excessive group according to UIC.The clinical data and thyroid related indexes of RPL patients in different iodine nutrition groups were analyzed and compared.（2）The 115 case patients diagnosed with intrauterine pregnancy and 47 pregnant women with no previous history of pregnancy loss were selected as the study subjects,divided into RPL group and control group.Patients of the RPL group were divided into spontaneous abortion group and normal pregnancy group according to pregnancy outcome.The differences of UIC and thyroid related indexes in RPL patients with different pregnancy outcomes were analyzed and compared.Result:（1）The median of urinary iodine in RPL patients was 266.85μg/L,and the patients were generally in an appropriate iodine nutritional state.Iodine deficiency group accounted for 7.53%（22/292）,iodine moderate group accounted for 48.63%（142/292）,iodine excess group accounted for 43.84%（128/292）.（2）There were no significant difference in age,residence,education,annual income,seafood,food addiction,biochemical pregnancy,biological pregnancy,unplanned pregnancy,and ectopic pregnancy in the three groups（P>0.05）.（3）The iodized salt consumption rate of iodine deficient group and iodine excess group was lower than that of iodine moderate group,and the difference was statistically significant（P<0.05）.（4）In iodine deficiency group,serum thyroid stimulating hormone（TSH）,number of previous spontaneous abortion was higher than iodine moderate group and iodine excess group（P<0.05）.The level of body mass index（BMI）and positive rate of antithyroid peroxidase antibody（TPOAb）in iodine excess group were higher than those in iodine moderate group（P<0.05）.（5）The median urinary iodine in RPL patients during early pregnancy was 259.10 μg/L,overall in a more-than-adequate state of iodine.Iodine deficiency group accounted for 11.30%（13/115）,iodine appropriate group accounted for 36.52%（42/115）,iodine more-than-adequate group accounted for 40.87%（47/115）,and iodine excess group accounted for 11.30%（13/15115）.（6）There was no significant difference in the UIC between the spontaneous abortion,normal pregnancy and control groups（P>0.05）.The incidence of iodine excess was higher in the spontaneous abortion group than that in the normal pregnancy group and control group,the difference was statistically significant（P<0.05）.（7）The level of TSH was higher in the spontaneous abortion group than that in the normal pregnancy group and control group,the difference is statistically significant（P<0.05）.There was no statistical difference between the TPOAb and TgAb in the three groups（P>0.05）.Conclusions:（1）RPL patients are in the appropriate state of iodine before pregnancy,and in the more-than-adequate state of iodine during early pregnancy.（2）In RPL patients,iodine nutritional status is associated with iodized salt consumption,the history of spontaneous abortion,BMI,TSH,and TPOAb.（3）The incidence of iodine overdose and the level of TSH during early pregnancy are higher in RPL patients with another spontaneous abortion than those in RPL patients with no miscarriages this time and early pregnant women with no previous history of pregnancy loss.（4）It is recommended to test the UIC for RPL patients combined with thyroid disease,and adjust the daily iodine nutrition intake timely and reasonably,and monitor the thyroid function and UIC during pregnancy,which may be of some positive significance for the re-pregnancy outcome of RPL patients.