Analysis and Exploration of Risk Factors for Intrauterine Adhesions in 188 Patients with Intrauterine Adhesions
Objective:To explore the risk factors of intrauterine adhesions in patients with intrauterine adhesions.Method:Clinical data were retrospectively collected from August 2020 to May 2021 from patients with intrauterine adhesions(188 cases)and patients with secondary infertility(149 cases)who underwent hysteroscopic surgery at Fujian Provicial Maternity and Child Health Hospital.The age,body mass index(BMI),the number of pregnancies,the number of deliveries,the number of miscarriages,last pregnancy status,and expression of CD38 and CD138 were compared between the two groups,and the factors affecting intrauterine adhesions were analyzed using logistic analysis.Result:The number of pregnancies,the number of deliveries,the number of miscarriages in the intrauterine adhesions group were significantly more than those in the secondary infertility group(P<0.05).The proportion of CD38 positivity in the intrauterine adhesions group was higher than that in the secondary infertility group(19.1%vs 10.7%),the difference was statistically significant(P<0.05).The proportion of CD138 positive and CD38/CD138 double positive in the intrauterine adhesions group compared to those the secondary infertility group,the differences were not statistically significant(P>0.05).Multivariate logistic regression analysis found that age[OR=0.876,95%CI(0.828,0.927)],ectopic pregnancy in the last pregnancy[OR=0.151,95%CI(0.066,0.345)],natural delivery[OR=0.242,95%CI(0.085,0.686)],and cesarean section[OR=0.163,95%CI(0.048,0.554)]were protective factors for intrauterine adhesions(P<0.05);the number of pregnancies was an independent risk factor for intrauterine adhesions[OR=1.729,95%CI(1.352,2.211),P<0.05].Conclusion:CD38 was highly expressed in the endometrium of patients with intrauterine adhesions;the number of pregnancies was an independent risk factor for intrauterine adhesions,and reducing unnecessary the number of pregnancies could reduce the occurrence of intrauterine adhesion.