Chronic intervillositis of unknown etiology in patients with recurrent pregnancy loss: Impact on reproductive outcomes, treatment efficacy, and recurrence rates
Bahi Fayek , Yang Doris Liu , Arshdeep Sidhu , Kimia Ziafat , Maya Geerts , Faten F. AbdelHafez , Jefferson Terry , Mohamed A. Bedaiwy
{"title":"Chronic intervillositis of unknown etiology in patients with recurrent pregnancy loss: Impact on reproductive outcomes, treatment efficacy, and recurrence rates","authors":"Bahi Fayek , Yang Doris Liu , Arshdeep Sidhu , Kimia Ziafat , Maya Geerts , Faten F. AbdelHafez , Jefferson Terry , Mohamed A. Bedaiwy","doi":"10.1016/j.placenta.2025.03.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to examine the influence of chronic intervillositis of unknown etiology (CIUE) on reproductive outcomes in patients with recurrent pregnancy loss (RPL), determine treatment effectiveness in future pregnancies, and estimate the CIUE recurrence rate.</div></div><div><h3>Materials and methods</h3><div>This retrospective study examined patients with RPL, categorizing them into CIUE and non-CIUE groups. Impact of CIUE on reproductive outcomes was assessed both cross-sectionally and longitudinally. A log-rank survival analysis was conducted to assess the effectiveness of various treatments on achieving ongoing pregnancies or live births following an initial episode of CIUE. Lastly, CIUE recurrence rate was evaluated.</div></div><div><h3>Results</h3><div>A total of 394 patients were included in the study: 23 in the CIUE group and 371 in the non-CIUE group. No significant differences were observed between the groups regarding baseline characteristics. Adjusted logistic regression showed that patients with CIUE had higher odds of experiencing preterm birth compared to non-CIUE patients (odds ratio [OR] = 3.15; 95 % confidence interval [CI]: 1.07–9.22). With each additional pregnancy, the non-CIUE group had 75 % increased odds of achieving live birth (OR 1.75; 95 % CI: 1.49–2.06), while the CIUE group's increase was not significant (OR 1.32; 95 % CI: 0.86–2.05). Additionally, the odds of stillbirth associated with additional pregnancies increased by 85 % in the CIUE group (OR 1.85; 95 % CI: 1.03–3.36), yet not significant in the non-CIUE group (OR 1.14; 95 % CI: 0.90–1.45). CIUE-treated patients had higher odds of achieving live birth or ongoing pregnancy after 24 months (P = 0.0491). CIUE recurred in 21.7 % of patients.</div></div><div><h3>Conclusion</h3><div>In the RPL population, CIUE adversely affected the reproductive outcomes. Despite its high recurrence rate, prophylactic treatment showed potential in improving outcomes.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"164 ","pages":"Pages 41-48"},"PeriodicalIF":3.0000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Placenta","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0143400425000803","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DEVELOPMENTAL BIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
This study aimed to examine the influence of chronic intervillositis of unknown etiology (CIUE) on reproductive outcomes in patients with recurrent pregnancy loss (RPL), determine treatment effectiveness in future pregnancies, and estimate the CIUE recurrence rate.
Materials and methods
This retrospective study examined patients with RPL, categorizing them into CIUE and non-CIUE groups. Impact of CIUE on reproductive outcomes was assessed both cross-sectionally and longitudinally. A log-rank survival analysis was conducted to assess the effectiveness of various treatments on achieving ongoing pregnancies or live births following an initial episode of CIUE. Lastly, CIUE recurrence rate was evaluated.
Results
A total of 394 patients were included in the study: 23 in the CIUE group and 371 in the non-CIUE group. No significant differences were observed between the groups regarding baseline characteristics. Adjusted logistic regression showed that patients with CIUE had higher odds of experiencing preterm birth compared to non-CIUE patients (odds ratio [OR] = 3.15; 95 % confidence interval [CI]: 1.07–9.22). With each additional pregnancy, the non-CIUE group had 75 % increased odds of achieving live birth (OR 1.75; 95 % CI: 1.49–2.06), while the CIUE group's increase was not significant (OR 1.32; 95 % CI: 0.86–2.05). Additionally, the odds of stillbirth associated with additional pregnancies increased by 85 % in the CIUE group (OR 1.85; 95 % CI: 1.03–3.36), yet not significant in the non-CIUE group (OR 1.14; 95 % CI: 0.90–1.45). CIUE-treated patients had higher odds of achieving live birth or ongoing pregnancy after 24 months (P = 0.0491). CIUE recurred in 21.7 % of patients.
Conclusion
In the RPL population, CIUE adversely affected the reproductive outcomes. Despite its high recurrence rate, prophylactic treatment showed potential in improving outcomes.
期刊介绍：
Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
