国际妇产科学杂志

国际妇产科学杂志 ›› 2026, Vol. 53 ›› Issue (2): 177-183.doi: 10.12280/gjfckx.20251181

• 产科生理及产科疾病: 论著 • 上一篇    下一篇

围孕期危险因素暴露与妊娠早期流产的关联：一项基于中国出生人口队列的前瞻性研究

张恩婕, 阴赪宏, 刘瑞霞, 祝慧萍, 刘建辉, 谢双华, 苏少飞()   

  1. 100026 首都医科大学附属北京妇产医院/北京妇幼保健院中心实验室（张恩婕， 阴赪宏， 刘瑞霞，刘建辉，谢双华，苏少飞）;首都医科大学公共卫生学院（祝慧萍）
  • 收稿日期:2025-10-22 出版日期:2026-04-15 发布日期:2026-05-08
  • 通讯作者: 苏少飞 E-mail:movingsu@mail.ccmu.edu.cn
  • 基金资助:
    北京市教育委员会科研计划项目(KM202310025006);国家重点研发计划项目(2016YFC1000101);北京市卫生系统高层次公共卫生技术人才建设项目领军人才(2022-1-003)

Association between Periconceptional Risk Factors Exposure and Early Pregnancy Abortion: A Prospective Study Based on the Chinese Birth Cohort

ZHANG En-jie, YIN Cheng-hong, LIU Rui-xia, ZHU Hui-ping, LIU Jian-hui, XIE Shuang-hua, SU Shao-fei()   

  1. Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China (ZHANG En-jie, YIN Cheng-hong, LIU Rui-xia, LIU Jian-hui, XIE Shuang-hua, SU Shao-fei); School of Public Health, Capital Medical University, Beijing 100069, China (ZHU Hui-ping)
  • Received:2025-10-22 Published:2026-04-15 Online:2026-05-08
  • Contact: SU Shao-fei E-mail:movingsu@mail.ccmu.edu.cn

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摘要： 目的：分析孕妇围孕期危险因素暴露与妊娠早期流产的关联。方法：选择2018年2月—2022年12月参加前瞻性中国出生人口队列研究的孕妇作为研究对象。采用电子数据采集系统收集信息。采用多因素Logistic回归模型分析围孕期危险因素暴露与妊娠早期流产的关联。结果：共纳入研究对象148 439例，孕妇年龄为（30.66±4.14）岁，妊娠早期流产发生率为2.30%（3 407例）。多因素Logistic回归模型分析结果显示，孕妇高龄（OR=2.52，95%CI：2.33~2.72）、研究生学历（OR=1.20，95%CI：1.05~1.38）、家庭年收入>40万元（OR=1.40，95%CI：1.25~1.56）、妊娠早期使用黄体酮/地屈孕酮（OR=1.09，95%CI：1.00~1.18）、妊娠早期下腹痛（OR=1.16，95%CI：1.07~1.27）、妊娠早期阴道出血（OR=1.11，95%CI：1.02~1.22）、孕妇吸烟（OR=2.73，95%CI：1.68~4.46）、孕妇饮酒（OR=1.26，95%CI：1.07~1.47）及家中使用空气污染有关化学品（OR=1.16，95%CI：1.05~1.28）是妊娠早期流产发生的危险因素（均P<0.05）。使用辅助生殖技术助孕受孕（OR=0.61，95%CI：0.52~0.72）和补充叶酸（OR=0.74，95%CI：0.66~0.83）可降低妊娠早期流产的风险（均P<0.05）。结论：高龄、学历较高、家庭年收入较高、妊娠早期使用黄体酮/地屈孕酮、妊娠早期下腹痛和阴道出血、吸烟和饮酒、家中使用空气污染有关化学品的孕妇，早期流产的发生风险增加。补充叶酸和辅助生殖技术助孕受孕的孕妇妊娠早期流产的发生风险有所下降。

关键词: 流产, 胚胎丢失, 危险因素, 队列研究, 回归分析

Abstract:

Objective: To analyze the association between maternal periconceptional risk factors exposure and early pregnancy abortion. Methods: Pregnant women who participated in the prospective China birth cohort study between February 2018 and December 2022 were selected as subjects. Information was collected using an electronic data capture system. Multivariate Logistic regression models were used to analyze the association between periconceptional risk factors exposure and early pregnancy abortion. Results: A total of 148 439 participants were included, with a mean maternal age of 30.66±4.14 years. The incidence of early pregnancy abortion was 2.30% (3 407 cases). Multivariate Logistic regression analysis showed that advanced maternal age (OR=2.52, 95%CI: 2.33-2.72), postgraduate education (OR=1.20, 95%CI: 1.05-1.38), annual household income >400 000 CNY (OR=1.40, 95%CI: 1.25-1.56), progesterone/dydrogesterone use in early pregnancy (OR=1.09, 95%CI: 1.00-1.18), lower abdominal pain in early pregnancy (OR=1.16, 95%CI: 1.07-1.27), vaginal bleeding in early pregnancy (OR=1.11, 95%CI: 1.02-1.22), maternal smoking (OR=2.73, 95%CI: 1.68-4.46), maternal alcohol consumption (OR=1.26, 95%CI: 1.07-1.47), and household use of air pollution-related chemicals (OR=1.16, 95%CI: 1.05-1.28) were risk factors for early pregnancy abortion (all P<0.05). Conception assisted by assisted reproductive technology (ART) (OR=0.61, 95%CI: 0.52-0.72) and folic acid supplementation (OR=0.74, 95%CI: 0.66-0.83) reduced the risk of early pregnancy miscarriage (both P<0.05). Conclusions: Advanced maternal age, higher education level, higher annual household income, progesterone/dydrogesterone use in early pregnancy, lower abdominal pain and vaginal bleeding in early pregnancy, smoking and alcohol consumption, and household use of air pollution-related chemicals are associated with an increased risk of early pregnancy abortion. Folic acid supplementation and ART-assisted conception are associated with a decreased risk of early pregnancy abortion.

Key words: Abortion, Embryo loss, Risk factors, Cohort studies, Regression analysis