Predicting first-trimester outcome of embryos with cardiac activity in women with recurrent spontaneous abortion

作     者：Li, Huixian Qin, Shuang Xiao, Fanfan Li, Yuhong Gao, Yunhe Zhang, Jiexin Xiao, Qing 

作者机构：Sun Yat Sen Univ Affiliated Hosp 8 3025 ShenNan Rd Shenzhen 518033 Guangdong Peoples R China Guangzhou Med Univ Inst Pediat Guangzhou Women & Childrens Med Ctr Guangzhou Guangdong Peoples R China Guangzhou Med Univ Guangzhou Women & Childrens Med Ctr Dept Reprod & Immunol Gynecol Guangzhou Guangdong Peoples R China Guangzhou Med Univ Dept Gynecol Outpatient Guangzhou Women & Childrens Med Ctr Guangzhou Guangdong Peoples R China 

出 版 物：《JOURNAL OF INTERNATIONAL MEDICAL RESEARCH》 (国际医学研究杂志)

年 卷 期：2020年第48卷第6期

页      面：300060520911829-300060520911829页

核心收录：

学科分类：1007[医学-药学(可授医学、理学学位)] 1001[医学-基础医学(可授医学、理学学位)] 10[医学] 

基　　金：Natural Science Foundation of Guangdong Province  China [2015A030313689] 

主　　题：First-trimester recurrent spontaneous abortion fetal ultrasound biomarker embryonic heart motion predictive value predictive algorithm 

摘      要：Objective This study was performed to evaluate the capability of routine clinical indicators to predict the early outcome of embryos with cardiac activity in women with recurrent spontaneous abortion (RSA). Methods A retrospective cohort study of pregnant women with a history of RSA in a Chinese tertiary hospital was performed using unadjusted and multivariable logistic regression. Results Of 789 pregnant women with RSA, 625 (79.21%) had ongoing pregnancy, whereas 164 (20.79%) developed abortion before 20 full weeks of gestational age even after embryonic heart motion was detected. The final model had an area under the curve of 0.81 (95% confidence interval, 0.78-0.84) with a sensitivity of 74.39%, a specificity of 76.00%, and a false-positive rate of 52.32% at a fixed detection rate of 90%. Conclusions The combination of multiple routine clinical indicators was valuable in predicting the early outcome of embryos with cardiac activity in viable pregnancies with RSA. However, this model might result in a high false-positive rate with a fixed detection rate of 90%;other markers must be investigated to identify first-trimester RSA once positive embryonic heart motion is established.