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首页> 美国卫生研究院文献>Journal of Clinical Medicine >Women with Recurrent Pregnancy Loss More Often Have an Older Brother and a Previous Birth of a Boy: Is Male Microchimerism a Risk Factor?
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Women with Recurrent Pregnancy Loss More Often Have an Older Brother and a Previous Birth of a Boy: Is Male Microchimerism a Risk Factor?

机译：患有复发性妊娠的妇女越来越多的兄弟和一个男孩的诞生：是男性微学体是一种危险因素吗？

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Known etiologic factors can only be found in about 50% of patients with recurrent pregnancy loss (RPL). We hypothesized that male microchimerism is a risk factor for RPL and aimed to explore whether information on family tree and reproductive history, obtained from 383 patients with unexplained RPL, was supportive of this hypothesis. The male:female sex ratio of older siblings was 1.49 (97:65) in all RPL patients and 1.79 (52:29) in secondary RPL (sRPL) patients, which differed significantly from the expected 1.04 ratio (p = 0.027 and p = 0.019, respectively). In contrast, the sex ratio of younger siblings was close to the expected ratio. Sex ratio of the firstborn child before sRPL was 1.51 (p = 0.026). When combined, 79.1% of sRPL patients had at least one older brother, a firstborn boy, or both. This differed significantly from what we expected based on the distribution of younger siblings and a general 1.04 sex ratio of newborns (p = 0.040). We speculate whether (s)RPL patients possibly acquired male microchimerism from older brother(s) and/or previous birth of boy(s) by transplacental cell trafficking. This could potentially have a detrimental impact on their immune system, causing a harmful response against the fetus or trophoblast, resulting in RPL.
机译：已知的病因因素只能在患有复发性妊娠损失（RPL）的约50％的患者中找到。我们假设男性微观程度是RPL的危险因素，旨在探索从383名未解释的RPL患者获得的关于家庭树和生殖史的信息，并支持这一假设。男性：较大的兄弟姐妹的女性比例为1.49（97:65）在所有RPL患者中，1.79（52:29）中的二次RPL（SRPL）患者，从预期的1.04比例显着不同（P = 0.027和P = 0.019分别）。相比之下，年轻兄弟姐妹的性别比率接近预期比率。在SRPL之前，第一个孩子的性比例为1.51（P = 0.026）。合并后，79.1％的SRPL患者至少有一个哥哥，统一男孩或两者。这与我们预期的基于年轻兄弟姐妹的分布以及新生儿的一般性比例不同（P = 0.040），这有显着不同（P = 0.040）。我们推测是否可能通过转脑细胞贩运从哥哥和/或之前的男孩诞生的男性微学体中获得雄性微型体。这可能会对其免疫系统产生有害影响，从而导致胎儿或滋养管的有害反应，导致RPL。

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