Abstract
BackgroundSeveral studies on the association of tumor necrosis factor alpha (TNF-α) polymorphisms with recurrent pregnancy loss (RPL) risk have reported conflicting results. The present meta-analysis was conducted to provide a more precise estimation of these relationships and to investigate the real association between TNF-α polymorphisms and RPL.MethodsAn extensive eligible literature search for relevant studies was conducted on PubMed, Embase, and The Cochrane Library from their inceptions to May 12, 2015. Specific inclusion criteria were used to evaluate articles. The odds ratio (OR) with 95% confidence intervals (CIs) were used to assess the strength of associations. Statistical analyses were performed by the STATA12.0 software.Results10 case–control studies including 1430 RPL patients and 1727 healthy controls were identified. Meta-analysis indicated that TNF-α-308G/A (rs1800629) polymorphism in the TNF-α gene correlated with elevated RPL risk whereas no significant association was observed between TNF-α-238G/A (rs361625) and RPL.ConclusionsThe current meta-analysis demonstrates that TNF-α-308G/A polymorphism in the TNF-α gene is associated with susceptibility to RPL.
Highlights
Several studies on the association of tumor necrosis factor alpha (TNF-α) polymorphisms with recurrent pregnancy loss (RPL) risk have reported conflicting results
In view of 12 eligible studies, the results indicate that tumor necrosis factor-α (TNF-α)-308G/A, −238G/A polymorphisms are not significantly associated with the risk of RPL in the overall population
Study characteristics We identified 19 articles that evaluated the association between TNF-α gene single nucleotide polymorphisms (SNP) and RPL risk. 10 of these studies met the eligibility criteria defined in the Materials and Methods section [16,17,18,19,20, 24,25,26,27,28]
Summary
Several studies on the association of tumor necrosis factor alpha (TNF-α) polymorphisms with recurrent pregnancy loss (RPL) risk have reported conflicting results. The present meta-analysis was conducted to provide a more precise estimation of these relationships and to investigate the real association between TNF-α polymorphisms and RPL. It is estimated that RPL affects approximately 3% of healthy women of reproductive age with undetermined causes [2, 3]. Tumor necrosis factor-α (TNF-α) is a potent cytokine which produced by mononuclear phagocytes, natural killer (NK) cells, and antigen-stimulated T-cells [10]. It has often been associated with increased risk for adverse pregnancy outcomes. Circulating levels of TNF-α are higher both in animals and humans with a miscarriage compared to those with a successful pregnancy, suggesting that this cytokine is exclusively harmful for pregnancy [8, 11,12,13]
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