Plasminogen activator inhibitor-1: is it a risk factor for recurrent miscarriage?

Abstract

Background: About 50% cases of recurrent miscarriages are idiopathic. The association of fibrinolytic defects with recurrent pregnancy failure is a novel research avenue and was first recommended in early 1990s. High Plasminogen activator inhibitor-1 (PAI-1) levels are found to be associated with recurrent miscarriage in various studies. The association of Plasminogen activator inhibitor -1 with recurrent pregnancy loss and its various variables are detrermined. Methods: This study was conducted at Ziauddin University Hospital Karachi, from Feb 2014 to Nov 2014. All non pregnant and non-obese women with history of consecutive two or more miscarriages, with no co-morbid diseases, visiting a gynecologist were included. Studied variables included were age, BMI, no. of miscarriages, time of miscarriage and plasma PAI-1 levels. The data was expressed in terms of median and percentages with a confidence interval of 95%. Analysis was done on SPSS version 20. Results: The median age of females was found to be 27.34± 5.09 years. Out of seventy five females with history of recurrent miscarriages, (81.3%) (n=61) women had Plasma PAI-1 levels within normal range whereas (18.7%) (n=14) had value greater than normal. The median plasma PAI-1 was found to be 29.6±22.16 ng/ml. Conclusion: PAI-1 was not found to be a risk factor for recurrent miscarriages in a local population of Karachi. Furthermore, studies on a large sample size need to be undertaken to assess the role of PAI-1in our population. Key Words: Recurrent pregnancy loss. Plasminogen activator inhibitor-1, Fibrinolysis