What’s new?
- Fibrinogen to Albumin ratio and Neutrophil to lymphocyte ratio levels
seem to be possible predictors for Recurrent Pregnancy Loss risk with
high sensitivity and specificity.
- Especially, higher Fibrinogen to Albumin ratio levels may be related
to an increase in thrombotic processes in recurrent miscarriage.
- Routine simple blood test parameters in the first trimester of
pregnancy may be useful in predicting recurrent pregnancy loss rather
than expensive genetic analyzes.
Introduction
Early pregnancy loss is a
frequently occurring disorder during the reproductive period, which
causes many psychological, social, and economic problems. Recurrent
abortions worsen these problems. Recurrent pregnancy loss (RPL) is
defined as two or more consecutive abortions that occur before the
twentieth gestational week in the absence of a previous delivery
[1,2,3]. The incidence of spontaneous pregnancy loss was reported in
almost 1 in 300 pregnancies [1]. According to epidemiological
studies, recurrent abortion was seen in 1% to 2% of all women in a
lifetime. Many factors have a role in RPL, such as aging, bad obstetric
history, and genetic and thrombotic problems [4].
The prothrombotic conditions affect maternal-fetal circulation and can
impair placental development. These thrombotic processes lead to venous
and/or arterial thrombosis, which can be responsible or contribute to
RPL. Therefore, antithrombotic strategies and/or prophylaxis regimens
are already being employed for medical management of recurrent
abortions. Thrombophilia panels were investigated to determine risky
populations [1, 5]. However, these panels are expensive and their
use is limited in the follow-up of treatment efficacy. Recently,
investigators focused on developing new and effective biomarkers for
monitoring prothrombotic populations. Especially, routine blood
parameters were investigated for vascular thrombotic processes [6,
7]. The immunopathological theory of RPL depends on decidual
inflammation, perivillous and decidual fibrin deposition, and
micro-thrombosis in decidual vessels that can be resulted in placental
implantation abnormalities. Moreover, many reports were focused on the
direct roles of the thrombotic and inflammatory processes in miscarriage7. However, the changes of standard laboratory markers
which are investigated other thrombotic and/or inflammatory disorders
were not comprehensively studied in RPL cases in previous studies.
The objective of this study, was to reveal the differences in routine
blood parameter tests as fibrinogen, D-dimer, fibrinogen to albumin
ratio (FAR), neutrophil to lymphocyte ratio (NLR), platelet count, main
platelet volume (MPV), and red cell distribution width (RDW) values
between pregnants with RPL and had no previous recurrent miscarriage.