PROBLEM To investigate risk factors that can help identify the possibility of pregnancy loss in threatened late miscarriage (TLM) patients with and without spontaneous uterine contractions. METHOD OF STUDY Amniotic immune biomarkers (IL2β receptor, IL6, IL8, IL10, IL1β, and TNFα) were assayed, and "sludge" was assessed. Patients without intrauterine infections were treated and followed up until delivery, and pregnancy outcomes were recorded. The two groups were compared for the differences in biomarker levels and "sludge," and the independent associations of biomarkers, "sludge," and other maternal factors with late miscarriage were investigated. RESULTS The amniotic levels of IL2βR, IL8, and TNFα were higher in the group with contractions (P < .05). When considered alone, each of the six biomarkers was significantly associated with late miscarriage in the no-contractions group and four of these (IL8, IL10, IL1β, and TNFα) in the contractions group (P < .05). Biomarker levels were correlated, and in multivariate Cox regression analysis, there was an independent effect only for IL8 in the no-contractions group (HR = 18.16, 95% CI: 5.75-57.43) and TNFα in the contractions group (HR = 4.11, 95% CI: 1.68-10.08). For patients with contractions, IL10, IL8, and IL1β were different in those with and without "sludge," but no such difference was seen in the no-contractions group. CONCLUSION For TLM patients without intrauterine infections, amniotic immune biomarkers differ between patients with different symptoms, not only for their levels but also for the impact of these biomarkers on the risk of late miscarriage. These findings suggest that the symptoms of TLM should be considered in the study of miscarriage risk.

中文翻译：

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羊水免疫生物标志物是具有晚期迟胎先兆的不同症状的女性的危险因素。

问题为了研究有助于确定有或没有自发性子宫收缩的晚期晚期流产（TLM）患者的妊娠流失的风险因素。研究方法测定羊膜免疫生物标记（IL2β受体，IL6，IL8，IL10，IL1β和TNFα），并评估“污泥”。对没有宫内感染的患者进行治疗并随访直至分娩，并记录妊娠结局。比较了两组在生物标志物水平和“污泥”方面的差异，并研究了生物标志物，“污泥”和其他母体因素与晚期流产的独立关联。结果收缩组的羊水IL2βR，IL8和TNFα较高（P <.05）。当单独考虑时，无收缩组的六个生物标志物中的每一个都与晚期流产显着相关，而收缩组中的四个（IL8，IL10，IL1β和TNFα）显着相关（P <.05）。生物标志物水平是相关的，在多变量Cox回归分析中，仅无收缩组（HR = 18.16，95％CI：5.75-57.43）和收缩组（HR = 4.11， 95％CI：1.68-10.08）。对于有收缩的患者，IL10，IL8和IL1β在有和没有“淤泥”的患者中是不同的，但是在无收缩组中没有这种差异。结论对于没有宫内感染的TLM患者，具有不同症状的患者之间的羊膜免疫生物标记物有所不同，不仅因为它们的水平，而且还因为这些生物标志物对晚期流产风险的影响。这些发现表明，在流产风险的研究中应考虑TLM的症状。