Family History Of Miscarriage Research Articles

Evaluation of platelet parameters, coagulation markers, antiphospholipid syndrome, and thyroid function in palestinian women with recurrent pregnancy loss

BackgroundMultiple etiologies contribute to recurrent pregnancy loss (RPL) including immunological, endocrine, anatomical, genetic and infection but more than 50% of cases remain unexplained. Evidences of thrombotic and inflammatory processes were observed at maternal-fetal interface and considered pathological findings in most RPL cases including unexplained cases. This study aimed to evaluate the association between RPL and several risk factors: platelet parameters, coagulation factors, antiphospholipid syndrome, and thyroid function.MethodsThis is an unmatched case-control study that included 100 RPL and 100 control women. Anthropometric and health data were collected and a gynecologist examined participants to assure fitting the inclusion criteria. Platelet parameters [including Mean Platelet Mass (MPM), Concentration (MPC) and Volume (MPV)] and ratios (MPV/Platelet, MPC/Platelet, MPM/Platelet, Platelet/Mononuclear cells), coagulation markers [Protein C (PC), Protein S (PS), Antithrombin III, D-dimer], antiphospholipid antibodies [Anti-phospholipid (APA), Anti-cardiolipin (ACA) and anti-B2-glycoprotein 1], Lupus anticoagulant, Antinuclear antibodies, and thyroid function (Thyroid stimulating hormone and anti-thyroid peroxidase) were measured.ResultsMean ages of cases and controls at marriage were 22.5 years for both, and their current ages were 29.4 and 33.0, respectively. 92% of cases and 99% of controls aged blow 30 years at marriage. 75% of cases have 3–4 miscarriages and 9% have ≥ 7 miscarriages. Our results indicated significantly lower male/female age ratio (p = .019), PC (p = .036) and PS (p = .025) in cases compared to controls. Plasma D-dimer (p = .020) and antiphospholipid antibodies [ACA (IgM and IgG), APA (IgM)] were significantly higher in cases compared to controls. No significant differences were observed between cases and controls concerning APA (IgG), anti-B2-glycoprotein 1 (IgM and IgG), Lupus anticoagulant, Antinuclear antibodies, platelet parameters, thyroid markers, family history of miscarriage, consanguineous marriage, and other health data.ConclusionsThis is the first study that investigated the association between platelet, coagulation, antiphospholipid, autoimmune and thyroid parameters, and RPL in Palestinian women. Significant associations between male/female age ratio, PC, PS, D-dimer, ACA (IgM, IgG), APA (IgM) and RPL were observed. These markers could be used in evaluating RPL. These findings confirm the heterogeneous nature of RPL and emphasize the need for further studies to find out risk factors for RPL.

Family history and risk of miscarriage: A systematic review and meta-analysis of observational studies.

Miscarriage, a spontaneous pregnancy loss at <24weeks' gestation, is a common complication of pregnancy but the etiologies of miscarriage and recurrent miscarriage are not fully understood. Other obstetric conditions such as preeclampsia and preterm birth, which may share similar pathophysiology to miscarriage, exhibit familial patterns, suggesting inherited predisposition to these conditions. Parental genetic polymorphisms have been associated with unexplained miscarriage, suggesting there could be a genetically inherited predisposition to miscarriage. This systematic review and meta-analysis of observational studies aimed to assess the association between family history of miscarriage and the risk of miscarriage in women. A systematic review and meta-analysis of observational studies was carried out in accordance with Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Electronic searches using databases (MEDLINE, EMBASE and CINAHL) were carried out to identify eligible studies from 1946 until 2019. Observational studies (cohort or case-control) were included. Human studies only were included. Participants were women of reproductive age. Exposure was a family history of one or more miscarriage(s). The primary outcome was miscarriage in women. Abstracts were screened and data were extracted by two independent reviewers. Study quality was assessed using Critical Appraisal Skills Program (CASP) tools. Data were pooled from individual studies using the Mantel-Haenszel method to produce pooled odds ratios (ORs) with 95% confidence intervals (95% CI). Systematic review registration number (PROSPERO): CRD42019127950. Thirteen studies were identified in the systematic review; 10 were eligible for inclusion in the meta-analysis. Twelve studies reported an association between family history of miscarriage and miscarriage in women. In all, 41287 women were included in the meta-analysis. Women who miscarried were more likely to report a family history of miscarriage (pooled unadjusted OR 1.90, 95% CI 1.37-2.63). Overall study quality and size varied, with few adjusting for confounding factors. Results should be interpreted with caution as the associations presented are based on unadjusted analyses only. Women who miscarry may be more likely to have a family history of miscarriage. Further research is required to confirm or refute the findings.

De novo exceptional complex chromosomal rearrangement in a healthy fertile male: case report and review of the literature

To report a de novo exceptional complex chromosomal rearrangement (CCR) with four breakpoints in the male partner of a couple with recurrent abortions. Case report and review of the literature. Genetics laboratory in a private hospital. A couple referred for recurrent abortions. Cytogenetic and sperm fluorescence in situ hybridization (FISH) techniques. Karyotype and FISH sperm results. The couple was phenotypically normal, with no family history of miscarriage or infertility. Female karyotype was normal. Male karyotype followed by FISH analysis showed a de novo CCR with four breakpoints: t(5,13,16)(q11.1, q14.3, q12.2), ins(16;13)(q12.2;q?q14.2). ish t(5;13;16)(wcp5+,wcp13+), ins(16;13)(wcp13+). Exceptional de novo CCR male carriers with recurrent abortions are extremely rare. Patients with CCRs have limited options to achieve a normal pregnancy. Careful consideration and assessment should be provided upon counseling of couples with CCRs.

Sonographic evaluation of uterine cervical dimension within 4-24 weeks of pregnancy

To determine the normal range of uterine cervix within 4-24 weeks of pregnancy and also assess whether variations are related to some selected extraneous human conditions. This was a prospective study conducted in University of Benin Teaching Hospital, Benin, Nigeria, and Nigerian National Petroleum Cooperation Health Centre, Warri, Nigeria. A prospective ultrasonographic (USS) study of uterine cervical dimension of 150 pregnant women within 4-24 weeks gestational age in two sonographic centers in Nigeria between January 2007 and October 2007 was conducted. The patients were examined by the authors. The uterine cervical dimensions (length, upper lip diameter, and lower lip diameter) were taken by means of ultrasonography. In addition, vital history, height and weight of patients were documented. The vital history included the age, number of childbirths, number of induced abortion, miscarriages and family history of miscarriages. Using Statistical program of social science (SPSS), the data were analyzed. Informed consent was obtained from all the patients and the study was done in line with the ethical guidelines of the centers. The following uterine cervical dimensions were obtained: mean cervical length of 6.14 cm and standard deviation of 2.0, and the upper and lower lips' uterine cervical diameters of 1.81 and 1.76 cm, respectively, with standard deviations of 0.86 and 0.71, respectively. There was no significant correlation of dimensions of uterine cervix to the aforementioned extraneous human condition. However, the increasing number of miscarriages correlated with decreasing length or shortness of the cervix. Uterine cervical dimension in pregnancy between 4 and 24 weeks is reproducible with sonographic documentation and the following normal ranges were deduced: cervical length (6.14 ± 2.0 cm), upper lip (1.81 ± 0.86 cm) and lower lip (1.76 ± 0.71 cm). The study revealed that increasing number of miscarriages was associated with effacement or reduction in the cervical length.

Risk factors for unexplained recurrent spontaneous abortion in a population from southern China

Objective To determine risk factors for recurrent spontaneous abortion (RSA) in women from southern China. Method We looked for associations between RSA and body mass index (BMI), family history of spontaneous abortion, smoking, exposure to environmental tobacco smoke (ETS [also known as passive smoking]), and alcohol and coffee consumption using an unconditional logistic regression model involving 326 patients with RSA and 400 controls. Results Whereas smoking, alcohol consumption, and coffee consumption were not associated with increased risk of RSA, both short (< 1 hour/day) and long (≥ 1 hour/day) periods of ETS were associated (adjusted odds ratio [OR], 2.30; 95% confidence interval [CI], 1.50–3.52 and adjusted OR, 4.75; 95% CI, 3.23–6.99, respectively). The increased risk of RSA was significant for participants with a BMI of 24.0 or greater (adjusted OR, 1.54; 95% CI, 1.12–2.14) and those with a family history of miscarriage (adjusted OR, 2.12; 95% CI, 1.28–3.49). Conclusion We found ETS, a higher BMI, and a family history of RSA to be independent risk factors for RSA in our population.

Association of ADAMTS13 Activity with Gender in Normal Adult Cohort

Background: the metalloprotease ADAMTS13 ( A Disintegrin And Metalloprotease with ThromboSpondin type 1 motif 13) cleaves von Willebrand within nascent platelet rich thrombi and its functional deficiency is associated with acute idiopathic or congenital thrombotic thrombocytopenic purpura (TTP). This disorder occurs more frequently in women especially during late pregnancy and postpartum period. However there is little information, some times controversial, on the protease behavior among healthy individuals in terms of gender and other demographic factors.Materials and methods: samples from 92 healthy Greek blood donors of childbearing age (17–50) were submitted. Fifty males, 42 females were tested (median age 38/33 respectively). The ADAMTS13 activity was measured by fluorescent technique (FRETS normal range >65%). Von Willebrand Factor Antigen and Activity as well as FVIII Activity were estimated by automated latex enhanced immunoassay. Whole blood count was determined concurrently. ABO phenotyping was performed. Demographic data (body mass index, blood pressure, parity) and social habits (cigarette smoking, alcohol intake ) were recorded. Pregnancy, preaclampsia, personal or family history of miscarriage, bleeding/thromboembolism, hypertension, use of oral contraception pills or any other medication were defined as exclusion criteria. All data were analyzed by Mann Whitney U-test, Kruskal Wallis statistics and Spearman's correlations. All individuals signed informed consent before sampling.Aim: we conducted a prospective study in order to measure ADAMTS13 activity in healthy population and identify possible factors that may influence enzyme's range.Results: statistical significance was obtained when we examined ADAMTS13 activity in terms of gender (138,42% versus 109,12 %-mean values-for males and females respectively, p<0,001). We found protease's activity below normal in 5 cases ( 4 females 26% –55%, 1 male 45% ) without any clinical relevance. Overall, there was a strong positive correlation between VWF:Ag and FVIII activity (p<0.001) and between VWF:Ag and VWF:Activity (p<0,001). Although ADAMTS13 activity decreased slightly with VWF:Ag increase there was no statistically significant inverse correlation between them. There was no difference in ADAMTS13 activity for the different blood groups. Negative correlation was revealed between platelets count and enzyme's activity (p=0.005). In females, nulliparous group reached lower values of ADAMTS13 activity compared to those of parous women though without statistical significance. There were no correlations between ADAMTS13 activity and age, body mass index or cigarette and alcohol use.Conclusions: the main finding of the present study is that plasma levels of ADAMTS13 activity differed significantly between the two genders. Yet previous studies have shown controversial results. In our knowledge this is the first attempt to measure ADAMTS13 activity in Greeks healthy individuals with age restriction (childbearing adults). In agreement with current literature on ADAMTS13 activity in pregnancy, where there is progressive decrease during gestation, we speculate the feasibility of oestrogen control over protease levels. Our results indicate probable hormonal penetration as mechanism which in part explains the different values we found between men and women. Probably is the lower ADAMTS13 activity, yet within normal, compared to men's, that leaves women more prone to TTP under predisposing conditions. This together with the preference of autoimmunity for women may offer an explanation on the higher incidence of TTP in females. The inverse correlation between ADAMTS13 activity and platelets count was unexpected and needs to be further investigated.