Hereditary thrombophilia and recurrent pregnancy loss: a systematic review and meta-analysis

Abstract STUDY QUESTION Is there an association between hereditary thrombophilia in pregnant women and risk of recurrent pregnancy loss (RPL)? SUMMARY ANSWER Pregnant with have increased RPL, especially for the G1691A mutation factor V Leiden (FVL) gene, G20210A prothrombin gene (PGM), deficiency protein S (PS). WHAT IS KNOWN ALREADY Prior studies suggested that a higher however, results are inconsistent; furthermore, complete overview is missing. This lack information obstacle to assessment RPL thrombophilia. A comprehensive meta-analysis on relation needed. DESIGN, SIZE, DURATION systematic review was performed using observational published English before 1 April 2020 evaluate RPL. PARTICIPANTS/MATERIALS, SETTING, METHODS Relevant were identified from PubMed, Web Science, EMBASE searches complemented perusal bibliographies retrieved articles. The exposure interest thrombophilia, including FVL mutation, PGM, antithrombin (AT), C (PC), PS. overall estimates pooled random effects models. Subgroup sensitivity analyses carried out explore possible sources heterogeneity assess robustness results. MAIN RESULTS AND THE ROLE OF CHANCE total 89 involving 30 254 individuals included. Results showed (odds ratio (OR): 2.44, 95% CI: 1.96–3.03), PGM (OR: 2.08, 1.61–2.68), or de?ciency PS 3.45, 1.15–10.35) had risks developing Compared reference group, no observed AT PC (all P > 0.05). Heterogeneity partially explained by geographic region, definitions types controlled confounders. Sensitivity validated findings. LIMITATIONS, REASONS FOR CAUTION Only 39 included one more confounders, across all high. Based data available, we cannot determine whether this confounded other potential factors WIDER IMPLICATIONS FINDINGS show suggesting testing should be considered FUNDING/COMPETING INTEREST(S) study funded Hunan Provincial Key Research Development Program (Grant number: 2018SK2062) National Natural Science Foundation 81973137). There conflicts interest. REGISTRATION NUMBER N/A.