Mathematical modeling of pregnancy loss with normal embryo karyotype in the first trimester

Abstract

Introduction. The risk of pregnancy loss in the first trimester comprises 12.5-18.7 %. It is timely and relevant to develop methods for predicting miscarriage.Aim: to develop a predictive model for assessing a risk of miscarriage in case of normal embryo karyotype.Materials and Methods. The single-center cohort retrospective comparative study included 52 women with miscarriage at 6-12 weeks of gestation with normal embryo karyotype (main group) and 126 women with physiologically proceeding pregnancies and favorable perinatal outcomes (control group). All patients underwent general clinical and laboratory examination, analysis of genetic polymorphisms (FGBG -455A, F2 G20210A, F5 G1691A, F7 G10976A, F13 G103A, PAI-1 -675 5G/4G, ITGA2 C708T, ITGB3 T176C, MTHFR C677T, MTHFR A1298C, MTR A2756G, MTRR A66G, NOS3 T-786C, NOS3 C894T), spouse examination.Results. The factors associated with the loss of pregnancy turned out to be presented by a history of infertility, patient adenomyosis, a higher platelet count, as well as abnormal partner spermogram. Significant differences were obtained between the studied groups in the frequency of concurrent polymorphisms PAI-1 -675 5G/4G, MTHFR C677T, MTRR A66G, NOS3 G894T. Based on the identified patterns, a mathematical model has been developed allowing to determine the high risk of pregnancy loss in the first trimester (86.0 % efficiency).Conclusion. A comprehensive assessment of clinical and anamnestic indicators, molecular genetic parameters, spouse-related health indicators, it is possible to determine risk groups of pregnancy loss in case a normal embryo karyotype. Timely prediction provides the basis for optimizing preconception care and conducting timely prevention of miscarriage.