| ObjectivesThrough the case-control study of the missed abortion patients and induced abortion patients,to explore the factors affecting missed abortion,at the same time to detect and analyze the levels of hormones and trace elements in the body,to explore the cause of missed abortion,to provide scientific basis for reducing the incidence of missed abortion.MethodsThis study was designed as a 1:1 frequency-matched case-control study.?1?From May 1,2018 to April 30,2019 in Lanzhou Maternal and Child Health Hospital and Jingning County Maternal and Child Health Hospital,84 patients with missed abortion were selected as the case group.91 normal pregnant women of the same age and the same gestational week who underwent artificial abortion were selected as the control group.The questionnaire was conducted by uniformly trained investigators to fill out a questionnaire on the factors affecting missed abortions.The information of the questionnaire was coded,entered,and collated using SPSS for statistical analysis;binary multivariate logistic regression was used to screen for the influencing factors of missed abortion.?2?In accordance with the principle of informed voluntary use,the venous blood of the case group and the control group was collected.Blood samples were obtained from 67 patients in the case group and 61 abortionists in the control group.The contents of several hormones in serum were determined.Serum?-human chorionic gonadotropin,progesterone,follicle stimulating hormone,luteinizing hormone,estradiol,testosterone,prolactin,insulin,placental prolactin and estriol were compared in the two groups.?3?21 pairs of serum samples were selected for detection of trace element and analysis.All subjects were in the same age group,at the same gestational week,and had no history of exposure to occupational hazards.The serum levels of mercury,manganese,nickel,copper,zinc,cadmium,arsenic and lead were compared between the two groups.the normal data were described with ???±s,the median and upper and lower quartiles were used to describe the skewed data,the t test and the rank sum test were used to compare the general condition,serum hormone levels and serum trace element levels of the two groups of pregnant women,and the risk factors of missed abortion were selected by Logistic regression.Results1.Among respondents,the average age of the missed abortion patients?N=84?was 30.86±5.49 years,the mean gestational week was 8.43±1.10 weeks.In the normal early pregnant women?N=91?,they were 30.03±5.68 years and 8.10±1.33 weeks,respectively.In the study subjects whose serum was measured,the average age of the missed abortion patients?N=67?was 30.57±5.49 years,the mean gestational week was 8.70±1.53 weeks.In the normal early pregnant women?N=61?,they were30.45±5.80 years and 8.20±1.42 weeks,respectively.In the study object of serum with trace elements detected,the average age of the missed abortion patients?N=21?was 30.33±6.61 years.The average age was 30.62±7.07 years in the normal early pregnant women?N=21?.The mean gestational week of both groups was 8.00±1.14weeks.There were no significant differences in age and gestational week between the two groups?P>0.05?.2.Regular consumption of seafood by pregnant women during pregnancy is a protective factor for missed abortion,OR=0.406?95%CI:0.2060.801?,P=0.009.The number of positive life events during pregnancy?3 was related to missed abortion,OR=0.234?95%CI:0.0750.733?,P=0.013.Pregnant women's exposure to pesticides in the last year was related to the occurrence of missed abortion,OR=2.830?95%CI:1.1586.913?,P=0.022.Pregnant women often eat fried pickled foods during pregnancy as a risk factor for missed abortions,OR=2.414?95%CI:1.2474.672?,P=0.009.Exposure noise in pregnant women three months before pregnancy was a risk factor for missed abortion,OR=5.340?95%CI:1.11925.480?,P=0.036.The pregnant spouse had a history of noise exposure three months before pregnancy associated with the occurrence of missed abortions,OR=3.273?95%CI:1.2908.300?,P=0.013.The pregnant spouse had a history of radiation and video radiation exposure three months before pregnancy as a risk factor for missed abortions,OR=2.482?95%CI:1.1455.381?,P=0.021.3.The high level of serum?-hCG in pregnant women was the protective factor for missed abortion,OR=0.988?95%CI:0.9790.996?,P=0.006.The high level of serum E2 in pregnant women was a protective factor for missed abortion,OR=0.145?95%CI:0.0570.366?and P=0.000.The high level of serum P in pregnant women was associated with the occurrence of missed abortion,OR=0.446?95%CI:0.2240.889?,P=0.022.4.The high level of serum Mn in pregnant women was the protective factor for missed abortion,OR=0.675?95%CI:0.468-0.973?,and P=0.030.The high level of serum Ni in pregnant women was the risk factor for missed abortion,OR=7.827?95%CI:1.027-59.680?,P=0.037,and the high level of serum Cd in pregnant women was the risk factor for missed abortion,OR=3.511?95%CI:2.532-4.868?,P=0.004.Conclusions1.The frequent consumption of seafood during pregnancy and the number of positive life events during pregnancy?3 are the protective factors for the missed abortion;the frequent consumption of fried pickled food during pregnancy,the history of pesticide exposure in the last year,the history of noise exposure before pregnancy and during pregnancy,the spouse's history of noise exposure before pregnancy and the history of radiation and video radiation exposure are the risk factors for the missed abortion.2.High serum?-hCG,E2 and P levels in pregnant women are protective factors for missed abortion.3.High serum Mn level in pregnant women is a protective factor for missed abortion,and high serum Ni and Cd levels are risk factors for missed abortion. |
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