ABSTRACT
Polymorphism A1/A2 in the ß3 subunit of integrins αIIb/ß3 and αV/ß3 is implicated in the risk of development of embryonic and fetal recurrent pregnancy loss (RPL). In 191 women with RPL, polymorphism A1/A2 was statistically significantly associated with RPL at <10 weeks of gestation (29.3% versus 16.4% in controls), but it was much more pronounced in 67 women with RPL between 10 and 20 weeks of gestation (41.8%), illustrating its role in recurrent fetal loss.
Subject(s)
Abortion, Habitual/genetics , Embryo Implantation/genetics , Integrin beta3/genetics , Placentation/genetics , Polymorphism, Genetic , Abortion, Habitual/pathology , Adult , Alleles , Antigens, Surface/genetics , Antigens, Surface/metabolism , Antigens, Surface/physiology , Case-Control Studies , Embryo Loss/genetics , Embryo Loss/pathology , Female , Genetic Predisposition to Disease , Gestational Age , Humans , Infertility, Female/genetics , Infertility, Female/pathology , Integrin beta3/metabolism , Integrin beta3/physiology , Polymorphism, Genetic/physiology , Pregnancy , Protein Subunits/genetics , Protein Subunits/metabolism , Protein Subunits/physiologyABSTRACT
To investigate the impact of maternal-inherited thrombophilia: effects of factor V Leiden (FVL) and prothrombin gene mutation (FII 20210G>A) on the development of recurrent pregnancy loss in embryonic and postembryonic periods. A total of 153 patients were analysed for FVL and FII 20210G>A according to placenta gestation: 94 women with embryonic loss prior 10 weeks of gestation and 59 women with postembryonic (early fetal) loss occurring between 10 and 14 weeks of gestation. The control group consisted of 100 healthy women, with at least one uncomplicated full-term pregnancy. FVL prevalence was not significantly associated with pregnancy loss prior to 10 weeks of gestation (9.6%) compared with controls (7%) [odds ratio (OR) 1.41; 95% confidence interval (CI) 0.454-4.416, P > 0.05], but it was much more pronounced in women with postembryonic loss (10-14 weeks of gestation) - 18.6% (OR 3.05; 95% CI 1.010-9.387, P = 0.047). FII 20210G>A was significantly higher in both groups with embryonic (17%) and early fetal losses (16.9%) as compared to controls (3%) (OR 6.63; 95% CI 1.731-29.752, P = 0.003; OR 6.60; 95% CI 1.572-31.856, P = 0.006). FII 20210G>A is significantly associated with an increased risk of early recurrent pregnancy loss throughout the entire first trimester. FVL was significantly higher only in early fetal period after starting of the placentation process, but not associated with embryonic recurrent pregnancy loss. These results suggested that the first trimester should be viewed rather as a heterogeneous interval, with different relation to FVL in the embryonic and postembryonic fetal period. Genetic testing should be applied according to the diverse contribution of thrombophilic markers to embryonic and postembryonic period.
