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Abstract

BACKGROUND:

The rates of pregnancy losses (PLs) are increased by maternal risk factors such as autoimmune disorders (AD) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms.

OBJECTIVE:

To evaluate singleton PLs before gestational week (gw) 22 among patients with AD and MTHFR polymorphisms.

METHODS:

Totally, 1108 singleton pregnancies in 243 women were categorized as: 1) 148 pregnancies in 33 patients with AD, 2) 316 pregnancies in 66 patients with MTHFR polymorphisms, 3) 644 pregnancies in 144 patients with AD $+$ MTHFR polymorphisms. PLs were classified into subgroups: a) Chemical Pregnancy(CP), b) Blighted Ovum(BO), c) gw $\leqslant$ 10, d) gw11–14 e) gw15–22, f) Ectopic Pregnancy(EP), g) Trophoblastic Disease(TD). Obstetric histories were compared using Beksac Obstetrics Index (BOI): [number of living child $+$ ( $\pi$ /10)]/gravida.

RESULTS:

PL rates before gw22 were 39.2% (58/148), 33.2% (105/316), and 36.3% (234/644) in AD, MTHFR, and AD $+$ MTHFR groups, respectively ( $p=$ 0.421). The rate of Pre-Prenatal Screening Period fetal losses (CP $+$ BO $+$ gw $\leqslant$ 10 fetal losses $+$ EP $+$ TD) were 84.8%, 75.9%, and 77.8% in AD, MTHFR, and AD $+$ MTHFR, respectively ( $p=$ 0.264). Gravidity $\leqslant$ 4 versus those with gravidity $\geqslant$ 5 had statistically significant differences in BOI ( $p<$ 0.001).

CONCLUSIONS:

PL rate before gw22 among singleton pregnancies with AD and/or MTHFR polymorphisms was 35.8%. The clinical findings seem to be more complicated in patients with gravidity $\geqslant$ 5.

Keywords

Autoimmune disorders methylenetetrahydrofolate reductase polymorphisms pregnancy loss miscarriage chemical pregnancy blighted ovum

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Singleton pregnancy losses before gestational week 22 among patients with autoimmune disorders and methylenetetrahydrofolate reductase polymorphisms

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Keywords

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References