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A Pilot Study on Multigenic Thrombophilic Risk in Recurrent Pregnancy Loss: Interactions Between MTHFR Polymorphisms
Oana-Viola Badulescu1,2, Monica Hancianu3, Cornelia Mircea3
1Department of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania.
Methylenetetrahydrofolate reductase (MTHFR) gene variants are linked to recurrent pregnancy loss in women with inherited thrombophilia. Homozygous MTHFR C677T and A1298C genotypes significantly increased miscarriage frequency.
Area of Science:
- Reproductive Genetics
- Thrombophilia Research
- Clinical Genetics
Background:
- Recurrent spontaneous miscarriage (RSM) is a significant reproductive issue.
- Inherited thrombophilia is a known risk factor for RSM.
- Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms (C677T, A1298C) are implicated in thrombotic events and adverse pregnancy outcomes.
Purpose of the Study:
- To evaluate the prevalence and role of MTHFR gene polymorphisms (C677T and A1298C) in the etiology of RSM.
- To compare MTHFR polymorphisms with classical thrombophilia markers (F5 Leiden, F2 G20210A) in women with inherited thrombophilia and RSM.
- To assess the association between MTHFR genotypes and the number of pregnancy losses.
Main Methods:
- Single-center retrospective observational study of 64 women with RSM and confirmed inherited thrombophilia.
- Genomic DNA analysis using a real-time PCR-based Bosphore Thrombophilia Panel for F5 Leiden, F2 G20210A, MTHFR C677T, MTHFR A1298C, SERPINE1 4G/5G, and F13A1 V34L.
- Statistical analysis including chi-square tests, Kruskal-Wallis analysis, and logistic regression models to assess genotype-clinical characteristic associations.
Main Results:
- Heterozygous MTHFR C677T (57.8%) and A1298C (53.1%) were the most frequent polymorphisms.
- Homozygous MTHFR C677T (p=0.001) and homozygous MTHFR A1298C (p=0.012) genotypes were significantly associated with a higher number of pregnancy losses.
- Classical thrombophilic mutations like F2 G20210A were less frequent but associated with increased pregnancy loss (p=0.030).
Conclusions:
- MTHFR gene polymorphisms, particularly homozygous variants, play a significant role in the etiology of recurrent pregnancy loss in women with inherited thrombophilia.
- Combined thrombophilic polymorphisms may contribute synergistically to recurrent pregnancy loss.
- Larger studies are warranted to confirm these findings and elucidate the precise mechanisms involved.
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