Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Department of Urology, Satu-Mare County Emergency Hospital, Strada Ravensburg 2, 440192 Satu-Mare, Romania.
Int J Environ Res Public Health. 2022 Dec 8;19(24):16500. doi: 10.3390/ijerph192416500.
Recurrent Pregnancy Loss (RPL) affects between 1% to 5% of women of reproductive age. It is widely believed that RPL is a complex disorder that is influenced by chromosomal abnormalities, genetic mutations, uterine anatomic deformity, endocrine dysfunction, immunologic factors, infections, and the environment. Thrombotic disorders are a frequent cause of RPL, accounting for almost half of all cases; however, in the rest of the cases, the cause of RPL remains unclear. Therefore, in this study, it was planned to determine the genetic mutations involved in RPL during the first and second trimester of pregnancy. An observational retrospective cohort study was conducted in 2021, collecting data from 157 first trimester miscarriages and 54 s trimester pregnancies. All patients with a panel of laboratory and genetic analysis for thrombophilia were included for data analysis. It was observed that four factors were significantly more prevalent in one of the groups. Factor V Leiden (FVL) homozygosity and antiphospholipid syndrome (APS) antibodies were statistically significantly more common in pregnant women who suffered first trimester pregnancy losses. On the other hand, Protein C deficiency and Glycoprotein Ia polymorphism were statistically significantly more frequent in the second trimester group. The strongest independent risk factors for first trimester pregnancy loss were FVL and prothrombin (PT) compound mutations (OR = 3.11), followed by FVL homozygous mutation (OR = 3.66), and APS antibodies (OR = 4.47). Regarding second trimester pregnancy loss risk factors, the strongest were FVL and PT compound (OR = 3.24), followed by Glycoprotein Ia polymorphism (OR = 3.61), and respectively, APS antibodies (OR = 3.85). Numerous thrombophilic risk factors for early and late pregnancy loss have been found, including several mutations that seem to occur more often either during the first or the second trimester. Even though we are aware of risk-free and efficient diagnostics for thrombophilia abnormalities, no intervention has been proved to be clearly successful after the detection of these variables.
复发性流产(RPL)影响着 1%至 5%的育龄妇女。人们普遍认为,RPL 是一种复杂的疾病,受到染色体异常、基因突变、子宫解剖畸形、内分泌功能障碍、免疫因素、感染和环境等因素的影响。血栓形成障碍是 RPL 的常见原因,几乎占所有病例的一半;然而,在其余病例中,RPL 的原因仍不清楚。因此,在这项研究中,计划确定妊娠早期和中期 RPL 涉及的遗传突变。2021 年进行了一项观察性回顾性队列研究,收集了 157 例早期流产和 54 例中期妊娠的数据。所有接受血栓形成倾向实验室和基因分析小组检查的患者均纳入数据分析。观察到有四个因素在其中一个组中更为普遍。因子 V 莱顿(FVL)纯合子和抗磷脂综合征(APS)抗体在早期妊娠流产的孕妇中更为常见。另一方面,蛋白 C 缺乏和糖蛋白 Ia 多态性在中期妊娠组中更为频繁。早期妊娠丢失的最强独立危险因素是 FVL 和凝血酶原(PT)复合突变(OR=3.11),其次是 FVL 纯合子突变(OR=3.66)和 APS 抗体(OR=4.47)。关于中期妊娠丢失的危险因素,最强的是 FVL 和 PT 复合(OR=3.24),其次是糖蛋白 Ia 多态性(OR=3.61),分别是 APS 抗体(OR=3.85)。已经发现了许多与早期和晚期妊娠丢失相关的血栓形成危险因素,包括几种似乎在早期或中期更常发生的突变。尽管我们已经知道了针对血栓形成异常的无风险和有效的诊断方法,但在检测到这些变量后,没有干预措施被证明是明确有效的。