BACKGROUND Recurrent pregnancy loss is a multifactorial disorder with potential underlying maternal hypercoagulability. OBJECTIVE We aimed to investigate whether a history of recurrent pregnancy loss poses an independent risk for future maternal long-term thromboembolic morbidity. STUDY DESIGN A population-based study compared the incidence of long-term thromboembolic morbidity in a cohort of women with and without a history of recurrent pregnancy loss. Data were collected from two databases that were cross-linked and merged: a computerized hospitalization database and a computerized obstetrics and gynecology perinatal database. Deliveries occurred between the years 1991-2017. The risk for long-term thromboembolic morbidity was based on the hospital's database and a pre-defined set of ICD codes of thromboembolic related hospitalizations. A Kaplan-Meier survival curve was constructed to compare the cumulative incidence of significant thromboembolic morbidity in the exposed and unexposed groups, and a Cox proportional hazards model, to control for confounders. RESULTS During the study period, 123,791 parturients met the inclusion criteria; 6.7 % n = 8247 of which experienced previous recurrent pregnancy loss-the exposed group. The rate of thromboembolic related hospitalizations was almost double in exposed women as compared to non-exposed 1.1 % vs. 0.6 %, OR = 1.8; 95 % 1.4-2.2; p < 0.001). Cumulative thromboembolic event incidence, as depicted in the survival curves, was also significantly higher among patients with recurrent pregnancy loss history (Log rank p < 0.001). The Cox model confirmed recurrent pregnancy loss history to be an independent risk factor for later maternal thromboembolic morbidity, while controlling for maternal age, known thrombophilia, ethnicity, smoking, hypertension, diabetes, and fertility treatment (aHR 1.27, 95 %CI 1.02-1.59, p=0.034). CONCLUSION A history of recurrent pregnancy loss is an independent risk factor for long-term thromboembolic morbidity, even in the absence of known maternal thrombophilia.

中文翻译：

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孕期反复流产的孕妇病史和血栓栓塞事件的长期风险。

背景技术反复流产是一种多因素疾病，可能具有潜在的潜在母体高凝性。目的我们旨在调查复发性流产的病史是否对将来的孕产妇长期血栓栓塞发病率构成独立的风险。研究设计一项基于人群的研究比较了一组有和没有复发性流产史的妇女中长期血栓栓塞症的发生率。数据是从两个相互关联和合并的数据库中收集的：计算机化住院数据库以及计算机化妇产科围产期数据库。交付发生在1991-2017年之间。长期血栓栓塞发病的风险是基于医院的数据库和预先定义的一组与血栓栓塞相关的住院ICD代码。构建Kaplan-Meier生存曲线，以比较暴露和未暴露组中明显的血栓栓塞发病率的累积发生率，以及Cox比例风险模型，以控制混杂因素。结果在研究期间，共有123,791名产妇达到了纳入标准。6.7％n = 8247，其中有先前经历过反复流产的孕妇-暴露组。暴露妇女的血栓栓塞相关住院率几乎是未暴露妇女的1.1％对比未暴露妇女的0.6％（OR = 1.8）。95％1.4-2.2；p <0.001）。如生存曲线所示，累积血栓栓塞事件的发生率在复发性流产史中也显着较高（Log rank p <0.001）。Cox模型证实复发的妊娠损失史是后来的母亲血栓栓塞症发病的独立风险因素，同时控制了母亲的年龄，已知的血栓形成，种族，吸烟，高血压，糖尿病和生育治疗（aHR 1.27，95％CI 1.02-1.59）。 ，p ＝ 0.034）。结论即使没有已知的母体血栓形成症，复发性流产史也是长期血栓栓塞症的独立危险因素。