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Fertil Steril. 2019 Sep;112(3):577-585.e3. doi: 10.1016/j.fertnstert.2019.05.003. Epub 2019 Jul 4.

Association of human leukocyte antigen-G 14 bp polymorphism with recurrent pregnancy loss in European countries: a meta-analysis of literature studies.

Author information

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.

KEYWORDS:

HLA-G 14 bp polymorphism; meta-analysis; recurrent pregnancy loss

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