摘要速递 | 孕前补体水平低可能与不良妊娠结局相关

题目：在纳入197名抗磷脂抗体或抗磷脂抗体导入剂的女性共260例妊娠的多中心研究中，发现孕前低补体水平与不良妊娠结局相关

期刊：生物医学

发表时间：2021年6月

关键词：抗磷脂抗体；抗磷脂综合征；补体；妊娠结局；妊娠

摘要翻译

在实验动物模型中，抗磷脂抗体（aPL）可诱导胎儿丢失。临床研究确实发现抗磷脂综合征（APS）患者的低补体早期与妊娠并发症相关，但这些结果均得到了一致的证实。

为了证实低补体水平（C3/C4）的检测是否可以被视为APS患者和aPL携带者发生不良妊娠结局（APO）的危险因素，我们进行了一项多中心研究，包括来自11个意大利和1个个俄罗斯中心的 503 例妊娠，其中 197 名孕妇的 260 例妊娠数据可用。

结果，显示与未出现妊娠并发症的女性相比，最后妊娠并发症的这部分患者补体水平普遍差异（p=0.0009，p＜0.0001）；

在孕前补体（C3/C4）水平较低的妊娠中，流产的发生率显着着升高（p=0.008）。同时针对三重aPL积极患者的亚组分析发现，孕前低C3和/或C4水平与妊娠丢失率增加相关（p=0.05）。

研究结果证实，怀孕前补体水平降低与APO风险增加有关。亚组分析中只见于具有三重aPL主动的女性，单主动或双主动表现显示这种趋势。本研究认为，补体水平的检测价格便宜并且易于测量，因此它们可以作为识别患者流产风险增加有用的辅助工具。

原版中文摘要：

Antiphospholipid antibodies (aPL) can induce fetal loss in experimental animal models. Human studies did find hypocomplementemia associated with pregnancy complications in patients with antiphospholipid syndrome (APS), but these results are not unanimously confirmed. To investigate if the detection of low C3/C4 could be considered a risk factor for adverse pregnancy outcomes (APO) in APS and aPL carriers' pregnancies we performed a multicenter study including 503 pregnancies from 11 Italian and 1 Russian centers. Data in women with APS and asymptomatic carriers with persistently positive aPL and preconception complement levels were available for 260 pregnancies. In pregnancies with low preconception C3/C4, a significantly higher prevalence of pregnancy losses was observed (p = 0.008). A subgroup analysis focusing on triple aPL-positive patients found that preconception low C3 and/or C4 levels were associated with an increased rate of pregnancy loss (p = 0.05). Our findings confirm that decreased complement levels before pregnancy are associated with increased risk of APO. This has been seen only in women with triple aPL positivity, indeed single or double positivity does not show this trend. Complement levels are cheap and easy to be measured therefore they could represent a useful aid to identify patients at increased risk of pregnancy loss.

参考文献：Nalli C, Lini D, Andreoli L, Crisafulli F, Fredi M, Lazzaroni MG, Bitsadze V, Calligaro A, Canti V, Caporali R, Carubbi F, Chighizola CB, Conigliaro P, Conti F, De Carolis C, Del罗斯 T、法瓦罗 M、杰罗萨 M、尤利亚诺 A、Khizroeva J、Makatsariya A、Meroni PL、莫斯卡 M、帕多万 M、佩里康 R、罗韦雷-奎里尼 P、塞巴斯蒂亚尼 GD、塔尼 C、托内洛 M、特鲁利亚 S、祖奇 D、 Franceschini F，Tincani A。一项多中心研究对 197 名患有抗磷脂综合征或抗磷脂抗体携带者的 260 名女性进行了 260 次妊娠研究，低孕前补体水平与不良妊娠结局相关。生物医药。2021 年 6 月 11 日；9(6):671。