Risk factors in immune-related recurrent spontaneous abortion and construction of predictive models.

Objectives: To explore the risk factors associated with immune-related recurrent spontaneous abortion (IRSA) and to develop a predictive model to identify high-risk individuals, aiming to provide theoretical guidance for RSA prevention.

Methods: This retrospective study included 120 patients with RSA who were treated at Jiangxi University of Traditional Chinese Medicine Hospital between January 2022 and January 2024. Patients were divided into two groups based on the nature of their miscarriages: the IRSA group (observation group, n=58) and the non-IRSA group (control group, n=62). Univariate and multivariate analyses were conducted to identify independent risk factors for IRSA. Using these factors, a nomogram prediction model was constructed and validated with R software (version 4.1.2).

Results: Independent prognostic factors for immune-related RSA included average platelet aggregation rate (95% CI 1.005-4.387; P=0.027), hemoglobin (95% CI 0.856-6.205; P=0.014), antiphospholipid antibodies (95% CI 0.954-5.465; P=0.024), triglycerides (TG) (95% CI 1.009-8.369; P=0.016), and free triiodothyronine (FT3) (95% CI 1.236-7.069; P=0.026). Using these factors, a nomogram was developed for predicting immune-related RSA incidence. The model achieved an AUC of 0.7975882 (95% CI 0.635-0.947), indicating good predictive accuracy, and decision curve analysis demonstrated positive net benefits.

Conclusion: FT3, TG, antiphospholipid antibodies, hemoglobin, and average platelet aggregation rate are independent risk factors for IRSA onset.