Study of incidence of antiphospholipid antibody syndrome and low vitamin D levels as an etiological factor in recurrent pregnanc loss and their correlation
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20163147Keywords:
Recurrent pregnancy loss (RPL), Antiphospholipid antibody (APLA), Vitamin DAbstract
Background: Recurrent pregnancy loss is a heterogeneous reproductive problem, with multiple etiologies. Objective of this study was to study the incidence of APLA syndrome and low vitamin d levels in RPL and correlation between APLA syndrome and low vitamin D levels.
Methods: This was an observational study conducted on 110 women seen in outpatient department/inpatient department of our institution from 1st August 2015 to 31st July 2016 who were known cases of RPL who fitted our inclusion and exclusion criteria.
Results: It was found that majority of the RPL patients were in the age group of 30-34 years (42.72%) and they contributed to 43% of the abortions. 77.4% abortions occurred in the gestational age of 6-8 weeks. 21.81% patients were APLA positive. 23.63% patients had low vitamin D levels. Out of the 21.81% patients who were APLA positive (50%) also had a low vitamin D level which was found to be statistically significant.
Conclusions: There appears to be some correlation between APLA syndrome and low vitamin D levels, so both have to be treated simultaneously. Properly investigating women for APLA syndrome and vitamin D deficiency would select a treatable group of women with RPL.
References
Serrano F, Lima ML. Recurrent miscarriage: psychological and relational consequences for couples. Psychol Psychother. 2006;79(Pt4):585-94.
Kolte AM, Bernardi LA, Christiansen OB, Quenby S, Farquharson RG, Goddijn M, et al. Stephenson on behalf of the eshre special interest group, early pregnancy. Terminology for pregnancy loss prior to viability: a consensus statement from the ESHRE special interest group, early pregnancy. Human Reprod. 2015;30(3):495-8.
The practice committee of the american society for reproductive medicine. Evaluation and treatment of recurrent pregnancy loss, a committee opinion. ASRM. 2012;98(5):1103-10.
RCOG guidelines the investigation and treatment of couples with recurrent first trimester and second trimester miscarriage. RCOG Green-top Guideline No. 17, 2011.
Pradhan T, Bhavthankar DP. An observational study of causes of recurrent pregnancy loss in rural population. Indian J Basic Appl Med Res. 2014;4(1):70-6.
Ota K, Dambaeva S, Han A, Beaman K, Gilman-Sachs A, Kwak-Kim J. Vitamin D deficiency may be a risk factor for recurrent pregnancy losses by increasing cellular immunity and autoimmunity. Human Reprod. 2014;29(2):208-19.
Balasch J, Creus M, Fabrogues F. Antiphospholipid antibodies and human reproductive failure. Hum. Reprod. 1996;11:2310-5.
van Niekerk EC, Siebert I, Kruger TF, An evidence-based approach to recurrent pregnancy loss. S Afr J OG. 2013;19(3):61-5.
Drakeley AJ, Quenby S, Farquharson RG. Mid-trimester loss-appraisal of a screening protocol. Hum Reprod. 1998;13(7):1975-80.
Orbach H, Zandman-Goddard G, Amital H, Barak V, Szekanecz Z, Szucs G, et al. Novel biomarkers in autoimmune diseases: prolactin, ferritin, vitamin D, and TPA levels in autoimmune diseases. Ann N Y Acad Sci. 2007;1109:385-40.
Agmon-Levin N, Blank M, Zandman-Goddard G, Orbach H, Meroni PL, Tincani A, et al. Vitamin D: an instrumental factor in the anti-phospholipid syndrome by inhibition of tissue factor expression. Ann Rheum Dis. 2011;70:145-50.