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Abstract
【Abstract】 Objective To explore the predictive value of prethrombotic state markers antithrombin -Ⅲ
(AT-Ⅲ), D-dimer (D-D), platelet aggregation rate, and vitamin D in patients with recurrent spontaneous
abortion (RSA). Methods A prospective study was conducted in 100 patients with RSA, who visited Hengshui People's Hospital from July 2023 to July 2024, were selected as the RSA group, including 32 cases with successful pregnancy maintenance (Group A), and 68 cases with failed pregnancy maintenance (Group B). Additionally, 100 healthy pregnant women with no history of miscarriage who underwent physical examination during the same period were selected as the control group. The general information of the subjects were collected, the levels of AT-Ⅲ, D-D, platelet aggregation rate and vitamin D were detected, and the diagnostic value of each indicator for miscarriage in RSA patients was evaluated.
Pearson correlation analysis was used to evaluate the correlation between AT-Ⅲ, D-D, platelet aggregation
rate,vitamin D and miscarriage in RSA patients.The risk factors for miscarriage in RSA patients were
analyzed by univariate and multivariate Logistic regression analysis. The predictive value of the combination of AT-Ⅲ, D-D, platelet aggregation rate, and vitamin D for miscarriage in RSA patients was evaluated using receiver operating characteristic (ROC) curve. Statistical analysis was performed using t-test, Kruskal-Wallis test and χ2 test. Results The levels of D-D and platelet aggregation rate in the RSA group were higher than those in the control group [(184.12±22.87) μg/L vs (123.16±23.91) μg/L, and (82.19±25.45)% vs (55.23±20.89)%, respectively; t values were 0.142 and 3.191, all P<0.05]. The levels of AT-Ⅲ and vitamin D in the RSA group were lower than those in the control group [(101.82±9.11)% vs
(117.91±17.21)%, (22.15±1.86) μg/L vs (36.25±3.87) μg/L, respectively; t values were 7.241 and
4.522, all P<0.05]. The levels of D-D and platelet aggregation rate in Group A were lower than those in
the Group B [(152.24±28.34) μg/L vs (192.42±25.93) μg/L, (63.21±21.49)% vs (83.22±23.82)%;
t values were 0.942 and 2.931, respectively, all P<0.05]. The levels of AT-Ⅲ and vitamin D in Group
A were higher than those in the Group B [(112.42±8.27)% vs (94.25±9.29)%, (26.51±1.32) μg/L vs
(21.22±1.82) μg/L; t values were 2.142 and 1.423, respectively, all P<0.05]. The results of multivariate
Logistic regression analysis showed that AT-Ⅲ, D-D, platelet aggregation rate, and vitamin D were the
risk factors for miscarriage in RSA patients (all P<0.05). The results of Pearson correlation analysis
showed that D-D levels and platelet aggregation rate were significantly positively correlated with
miscarriage in RSA patients (r values were 0.742 and 0.821, respectively, all P<0.05), while the levels of
AT-Ⅲ and vitamin D were significantly negatively correlated with miscarriage in RSA patients (r values
were -0.842 and -0.572, respectively, all P<0.05). The results of ROC curve analysis showed that AT-Ⅲ,
D-D, platelet aggregation rate, and vitamin D levels had independent predictive value for miscarriage in
RSA patients, especially when used in combination of four indicators (the area under the curve was 0.923,
95% CI: 0.881-0.965, P<0.001). Conclusion AT-Ⅲ, D-D, platelet aggregation rate, and vitamin D levels
all provide strong support for miscarriage risk assessment in RSA patients, and the combined application of
these indicators can further improve predictive accuracy.
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2026, Vol. 14 
