A comprehensive Bayesian analysis assessing the effectiveness of lymphocyte immunotherapy for recurrent spontaneous abortion

IF 6 Life medicine Pub Date : 2023-12-08 DOI:10.1093/lifemedi/lnad049
Rongzhou Chen, Haohan Xu, Yujia Hou, Hanghang Liu, Zheng Zheng, Shaohua Ma
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Abstract

Recurrent spontaneous abortion (RSA) affects 2%–5% of couples worldwide and remains a subject of debate regarding the effectiveness of lymphocyte immunotherapy (LIT) due to limited retrospective studies. We conducted a comprehensive Bayesian analysis to assess the impact of LIT on RSA. Using data from the Shenzhen Maternity and Child Healthcare Hospital (2001–2020, n = 2,316), a Bayesian generalized linear model with predictive projection feature selection was employed. Our analysis revealed a significant improvement in live birth rates for RSA patients undergoing LIT. Notably, LIT had a greater impact compared to the other 85 factors considered. To mitigate research bias, we conducted a Bayesian meta-analysis combining our dataset with 19 previously reported studies (1985–2021, n = 4,246). Additionally, we developed an empirical model highlighting the four key factors, they are LIT result, age, paternal blood type and anticardiolipin antibody. Younger age (19–27), paternal blood type B, and a positive anticardiolipin antibody (IgM) were associated with better therapeutic outcomes in LIT for RSA. These findings aid clinicians in identifying suitable candidates for LIT and improving treatment outcomes.
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评估淋巴细胞免疫疗法对复发性自然流产疗效的贝叶斯综合分析
复发性自然流产(RSA)影响全球2%-5%的夫妇,由于回顾性研究有限,关于淋巴细胞免疫治疗(LIT)的有效性仍然是一个争论的主题。我们进行了全面的贝叶斯分析来评估LIT对RSA的影响。使用深圳市妇幼保健院2001-2020年的数据,n = 2316),采用具有预测投影特征选择的贝叶斯广义线性模型。我们的分析显示,接受LIT治疗的RSA患者的活产率显著提高。值得注意的是,与其他85个因素相比,LIT的影响更大。为了减少研究偏差,我们将我们的数据集与19项先前报道的研究(1985-2021,n = 4,246)结合起来进行了贝叶斯荟萃分析。此外,我们建立了一个实证模型,突出了四个关键因素,即LIT结果、年龄、父亲血型和抗心磷脂抗体。年龄较小(19-27岁)、父亲B型血和抗心磷脂抗体(IgM)阳性与RSA的LIT治疗效果较好相关。这些发现有助于临床医生确定合适的LIT候选人并改善治疗结果。
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