PROBLEM:It is unclear if the immunologic alterations induced by pregnancy could persist. METHOD OF STUDY:Antenatal rubella sero-negativity was correlated with gravidity, abortions and parity in 112 083 gravidae managed during 1997-2015, with further analysis stratified for factors known to influence rubella serology. RESULTS:The 10.2% sero-negative gravidae had different characteristics, and the incidence showed significant difference and positive trend (P<.001 for both) with gravidity, abortions and parity. The pattern remained consistent when analysis was stratified for advanced age, high body mass index and medical history, but was negated by hepatitis B virus infection except for abortions, and by high body mass index for parity. For gravidity 2-4, no difference in rubella sero-negativity was found between gravidae with all previous pregnancies ended in abortion vs delivery. CONCLUSION:Prior pregnancies diminished rubella immunity in a dose-dependent manner, which may be a reflection of the cumulative effect of pregnancy-associated maternal immunologic alteration.

译文

问题:目前尚不清楚怀孕引起的免疫学改变是否会持续下去。
研究方法:1997年至2015年期间管理的112 083名孕妇的产前风疹血清阴性与妊娠率,流产和胎次相关,并对已知影响风疹血清学的因素进行了进一步分析。
结果:10.2%血清阴性的孕妇具有不同的特征,其发病率与妊娠,流产和产后均表现出显着差异和阳性趋势(两者均P <.001)。当对高龄,高体重指数和病史进行分层分析时,该模式保持一致,但被流产除外的乙型肝炎病毒感染和均等的高体重指数所抵消。对于妊娠2-4,在流产与分娩之前所有妊娠结束的妊娠之间,风疹血清阴性没有发现差异。
结论:早孕以剂量依赖性方式降低风疹免疫力,这可能反映了妊娠相关的母体免疫学改变的累积作用。

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