Полиморфизмы генов системы гемостаза у женщин с привычным невынашиванием беременности

Abstract

The objective: to evaluate the prevalence of hemostasis and folate cycle gene polymorphisms in patients with a history of miscarriage. Materials and methods. A survey was conducted of 125 women with habitual miscarriage who were in the first, main, group. The criteria for inclusion of patients in the study were the presence of two or more pregnancy losses in the anamnesis up to 22 weeks. The exclusion criteria were anatomical, endocrine, infectious, immunological, social causes of miscarriage, and the presence of benign uterine tumors and antiphospholipid syndrome. Group II (control) included 40 somatically healthy women, without reproductive losses, with a history of at least one physiological pregnancy. All women underwent a molecular genetic study of 8 hemostatic system genes and 4 folate cycle genes by a multiplex allele-specific polymerase chain reaction in real time. Results. As a result of the analysis in women with habitual miscarriage, statistically significantly more often revealed: homozygous polymorphism for the gene FGB 455G> A, ITGA2 (α2-integrin) C807T, both homo- and heterozygous forms, homozygous polymorphism 5GG75GG7575G > 4G – homo- and heterozygous forms, as well as polymorphism of MTHFR 677C> T and MTHFR 1298A> C genes. A statistically significant association of ITGA2 807C> T and PAI-1 675 5G> 4G polymorphisms was confirmed with more than six and sevenfold increased odds of habitual miscarriage (p=0.0002 and 0.0001, respectively). Carrying the mutant allele of the FGB 455G> A gene was associated with a 3.6-fold increase in the chances of reproductive loss. Multigenic forms of thrombophilia were detected in 109 (87.2%) women of the main group, which was 3.5 times higher than the corresponding indicators in the control group – 10 (25.0%); p <0.05. Conclusion. In order to prevent recurrent reproductive losses in patients with a history of pregnancy miscarriage, with the exception of other causes, it is necessary to carry out an examination for the presence of clotting and folate cycle polymorphisms. Detection of the carrier of mutant alleles in patients with pregnancy miscarriage will help to properly study the activity of certain parts of the hemostasis system, to adequately select therapy and to realize the reproductive function of a woman. Key words: habitual miscarriage, pregnancy polymorphism of hemostasis genes, folate cycle.