Marcello Monti1, Roberta Lupoli2, Loredana Maria Sosa Fernandez3, Ferdinando Cirillo4, Matteo Nicola Dario Di Minno5. 1. Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy. Electronic address: marcello.monti@unina.it. 2. Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy. 3. Centro Embryos, Centro di Fecondazione Assistita, Naples, Italy. 4. Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy. 5. Department of Translational Medical Sciences, "Federico II" University, Naples, Italy.
Abstract
OBJECTIVE: To study the controversial association between human leukocyte antigen-G (HLA-G) 14 bp polymorphism and recurrent pregnancy loss (RPL). We performed a meta-analysis of studies in the literature that enrolled only women of European countries who experienced RPL spontaneously or after undergoing IVF. DESIGN: Systematic meta-analysis of articles published before January 2019 pertaining the association of HLA-G genotype and RPL. The search was performed in electronic databases (PubMed, Web of Science, Scopus, EMBASE), without any language or publication year restriction. SETTING: Academic hospitals and private clinics. PATIENT(S): Women who experienced RPL spontaneously or after undergoing IVF. INTERVENTION(S): Genotyping of 14 bp polymorphism (insertion/insertion, insertion/deletion, deletion/deletion) in exon 8 of the HLA-G gene. MAIN OUTCOME MEASURE(S): Meta-analyses of the association between HLA-G 14 bp polymorphism in homozygosis (insertion/insertion) and heterozygosis (insertion/deletion) in women with RPL compared with pregnant controls with at least one live birth and no history of RPL. RESULT(S): Ten studies were analyzed comprising 1,091 women with RPL and 808 controls without RPL. Women with RPL showed significantly higher prevalence of HLA-G 14 bp insertion/insertion genotype compared with women without RPL (19.8% vs. 14.1%; odds ratio = 1.562; 95% confidence interval, 1.203-2.027), and this result was also confirmed when separately analyzing women with RPL during a spontaneous pregnancy (odds ratio, 1.562; 95% confidence interval, 1.203-2.027) and those undergoing IVF (odds ratio, 1.990; 95% confidence interval, 0.978-4.051). CONCLUSION(S): Women of European countries with the HLA-G 14 bp insertion/insertion genotype have a significantly higher prevalence of RPL.
OBJECTIVE: To study the controversial association between human leukocyte antigen-G (HLA-G) 14 bp polymorphism and recurrent pregnancy loss (RPL). We performed a meta-analysis of studies in the literature that enrolled only women of European countries who experienced RPL spontaneously or after undergoing IVF. DESIGN: Systematic meta-analysis of articles published before January 2019 pertaining the association of HLA-G genotype and RPL. The search was performed in electronic databases (PubMed, Web of Science, Scopus, EMBASE), without any language or publication year restriction. SETTING: Academic hospitals and private clinics. PATIENT(S): Women who experienced RPL spontaneously or after undergoing IVF. INTERVENTION(S): Genotyping of 14 bp polymorphism (insertion/insertion, insertion/deletion, deletion/deletion) in exon 8 of the HLA-G gene. MAIN OUTCOME MEASURE(S): Meta-analyses of the association between HLA-G 14 bp polymorphism in homozygosis (insertion/insertion) and heterozygosis (insertion/deletion) in women with RPL compared with pregnant controls with at least one live birth and no history of RPL. RESULT(S): Ten studies were analyzed comprising 1,091 women with RPL and 808 controls without RPL. Women with RPL showed significantly higher prevalence of HLA-G 14 bp insertion/insertion genotype compared with women without RPL (19.8% vs. 14.1%; odds ratio = 1.562; 95% confidence interval, 1.203-2.027), and this result was also confirmed when separately analyzing women with RPL during a spontaneous pregnancy (odds ratio, 1.562; 95% confidence interval, 1.203-2.027) and those undergoing IVF (odds ratio, 1.990; 95% confidence interval, 0.978-4.051). CONCLUSION(S): Women of European countries with the HLA-G 14 bp insertion/insertion genotype have a significantly higher prevalence of RPL.
Authors: Izabela Nowak; Karolina Wilczyńska; Paweł Radwan; Andrzej Wiśniewski; Rafał Krasiński; Michał Radwan; Jacek R Wilczyński; Andrzej Malinowski; Piotr Kuśnierczyk Journal: Front Immunol Date: 2020-01-14 Impact factor: 7.561