Int J Lab Hem. 2017;1–6. wileyonlinelibrary.com/journal/ijlh
|
1 © 2017 John Wiley & Sons Ltd
Received: 2 March 2017
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Accepted: 24 April 2017
DOI: 10.1111/ijlh.12703
ORIGINAL ARTICLE
Thrombophilic gene polymorphisms and recurrent pregnancy
loss in Greek women
M. Chatzidimitriou
1
| D. Chatzidimitriou
2
| M. Mavridou
1
| C. Anetakis
1
|
F. Chatzopoulou
2
| T. Lialiaris
3
| S. Mitka
1
1
Medical Laboratories, Alexandre
Technological Institute of Thessaloniki,
Thessaloniki, Greece
2
Medical School, Aristotle University of
Thessaloniki, Thessaloniki, Greece
3
Medical School, Demokritus University of
Thrace, Thessaloniki, Greece
Correspondence
Maria Chatzidimitriou, Medical Laboratories,
Alexandre Technological Institute of
Thessaloniki, Thessaloniki, Greece
Emails: chatzidi@med.auth.gr, mchatzid952@
gmail.com
Abstract
Introduction: Recurrent pregnancy loss (RPL) is a multifactorial disorder. The aim of
this study was the detection of various genetic polymorphisms and their correlation to
RPL, in Greek women.
Methods: The impact of 12 thrombophilic polymorphisms was evaluated, among 48
Greek women with a history of RPL, vs 27 healthy parous women. Multiplex PCR and
in situ hybridization on nitrocellulose films were performed, to investigate 12 genetic
polymorphisms previously reported as risk factors for RPL.
Results: Heterozygous FV Leiden, homozygous PAI-1 4G/4G, heterozygous MTHFR
C677T, homozygous MTHFR A1298C, as much as the combined thrombophilic geno-
types MTHFR 677T + ACE Ι/D, MTHFR 677T/1298C + ACE D/D, ACE I/D + b-
fibrinogen -455 G/A, FV HR2 + b-fibrinogen -455 G/A showed a correlation as risk
factors for RPL, whereas the rest of the investigated polymorphisms and their combi-
nations did not render statistically significant differences between the two groups in
study.
Conclusion: The results of this study, as well as those of similar studies, concerning the
detection of genetic, environmental, and physiological factors underlying RPL, will
prove of critical significance in the investigation and treatment of thrombophilic pre-
disposition, in cases of RPL.
KEYWORDS
gene polymorphisms, genetic risk factors, in situ hybridization, recurrent pregnancy loss,
thrombophilia
1 | INTRODUCTION
Recurrent pregnancy loss (RPL) is the occurrence of two or more con-
secutive fetal loss prior to 20 weeks gestation or at the time when the
fetus weighs less than 500 g.
1
Spontaneous abortion is the most com-
mon complication of pregnancy, affecting approximately 10%-15% of
clinically recognized pregnancies.
2
As much as RPL is one of the most
common reproductive complications, it is also one of the least under-
stood pathophysiological processes..
3
As there is no known cause for
50% to 75% of this condition, the involvement of genetic risk factors
is postulated to contribute in the etiology of RPL.
4
Pregnancy is a hypercoagulable state characterized by increased
levels of prothrombotic factors and decreased antithrombotic fac-
tors. Hemostatic failures may cause an obstruction of the placental
circulation; hence, unexpected changes in coagulation factors during
pregnancy may be the reason for RPL.
5
As of late, the association of
RPL with maternal thrombophilic or hypofibrinolytic gene variants
has assembled growing evidence.
6
Such thrombophilias augment the
prothrombotic state of pregnancy, lead to inadequate fetomaternal
circulation, and affect the process of placentation in the developing
embryo.
2
In literature, twelve thrombophilic gene variants of ten ge-
netic loci are largely associated with an increased risk of pregnancy