Analysis of Risk Factors and Prediction Model of Chromosomal Abnormalities in Embryos from Patients with Missed Miscarriage

Mengke Wei,1,* Qiankun Wei,2,* Xinyan Xu,3 Shuang Liu,3 Xuzhen Zhao,1 Zhiping Zeng,1 Yuning Dai,1 Patiman Ainiwaer,2 Jing Zhang3 1School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, 830000, People’s Republic of China; 2School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, People’s Republic of China; 3Xinjiang Clinical Research Center for Perinatal Diseases, Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, 830000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Zhang, Xinjiang Clinical Research Center for Perinatal Diseases, Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang, 830000, People’s Republic of China, Email [email protected]: To study the chromosome distribution characteristics in embryos of patients with missed miscarriage and analyze the risk factors of embryonic chromosomal abnormalities.Methods: Clinical data were collected from 216 hospitalised patients diagnosed with missed miscarriages who successfully underwent embryo chromosomal analysis at the Urumqi Maternal and Child Health Hospital between January 2022 and August 2024. The distribution of embryonic chromosomes was investigated, and risk factors for chromosomal abnormalities were identified using multivariate logistic regression analysis. Based on the above-described results, a nomogram prediction model was established and validated. The receiver operating characteristic curve was plotted, the area under the curve (AUC) was calculated, and the calibration curve and clinical decision curve were plotted to verify the model discrimination, calibration, and clinical practicability.Results: Our results showed that the rate of chromosomal abnormalities in patients with missed miscarriages was 66.67%; among these, trisomy 16 (45, X) and triploidy were the most common numerical abnormalities, while deletions were the predominant structural abnormality. Being underweight or overweight, insufficient or deficient in 25-hydroxyvitamin D, and having elevated thyroid-stimulating hormone levels were identified as risk factors for developing embryonic chromosomal abnormalities (P< 0.05). Based on the above results, a nomogram prediction model was constructed with an AUC of 0.887 (95% CI: 0.833~0.940). The Hosmer–Lemeshown goodness-of-fit test indicated a good fit (χ2 = 11.452, p = 0.177) and the calibration and clinical decision curve results suggested good calibration degree and clinical practicability.Conclusion: Chromosomal abnormalities are the main causes of missed miscarriages, with trisomy 16 and Turner syndrome being the most common among these. A close correlation between weight in women and embryonic chromosomal abnormalities was observed. Vitamin D deficiency or insufficiency and elevated thyroid-stimulating hormone levels may also contribute to increased risk of chromosomal abnormalities in embryos.Keywords: miscarriage, chromosomal aberrations, body mass index, thyroid, vitamin D