HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sotiriadis, A. Articles by Kalantaridou, S. N. Search for Related Content PubMed PubMed Citation Articles by Sotiriadis, A. Articles by Kalantaridou, S. N. Related Collections Meta-analysis Reproductive endocrinology Abortion

Fibrinolytic Defects and Recurrent Miscarriage

A Systematic Review and Meta-Analysis

From the ¹Department of Obstetrics and Gynecology, University Hospital of Ioannina, Greece; and ²Laboratory of Human Reproduction, Department of Obstetrics and Gynecology, Medical School, University of Crete, Heraklion, Greece.

OBJECTIVE: To systematically review evidence of the association between fibrinolytic defects and recurrent miscarriage.

DATA SOURCES: MEDLINE, EMBASE, and references of retrieved articles (last update September 2006) were used.

METHODS OF STUDY SELECTION: Studies comparing the prevalence of fibrinolytic defects in patients with recurrent miscarriage and control women were reviewed. Of 111 potentially relevant studies, data from 14 were integrated with meta-analytic techniques and were presented as odds ratios (ORs).

TABULATION, INTEGRATION, AND RESULTS: Plasminogen activator inhibitor-1 4G/5G polymorphism (OR 1.65, 95% confidence interval [CI] 0.92–2.95) and increased plasminogen activator inhibitor activity were not significantly associated with recurrent miscarriage, although the latter showed profound heterogeneity across studies. Although factor XII C46T polymorphism is not associated with recurrent miscarriage (OR 1.07, 95% CI 0.52–2.22), factor XII deficiency is significantly associated (five studies, 1,096 women; OR 18.11, 95% CI 5.52–59.39), with minimal heterogeneity across studies. Factor XIII Val34Leu and Tyr204Phe polymorphisms were not associated with recurrent miscarriage (OR 1.24, 95% CI 0.46–3.34 and OR 2.61, 95% CI 0.45–15.16, respectively). There were no eligible studies found for the rest of the factors searched (urokinase-type plasminogen activator, tissue-type plasminogen activator, kallicrein, a2-antiplasmin, a2-macroglobulin, thrombin-activated thrombolysis inhibitor, and factor XI). Only a small minority of studies ascertained miscarriage according to specific criteria, and none of the studies provided equal examination for confounders in cases and controls.

CONCLUSION: Factor XII deficiency is associated with recurrent miscarriage. Data on the other factors either fail to show association or are quite limited.

This article has been cited by other articles:

				The ESHRE Capri Workshop Group Genetic aspects of female reproduction Hum. Reprod. Update, April 2, 2008; (2008) dmn009v1. [Abstract] [Full Text] [PDF]