CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(10): 631-641
DOI: 10.1055/s-0038-1672137
Review Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Association of Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism with Recurrent Pregnancy Loss: a Meta-Analysis of 26 Case-Control Studies

Fereshteh Aslbahar
1   Department of Obstetrics and Gynecology, Semnan University of Medical Sciences, Semnan, Iran
,
Hossein Neamatzadeh
2   Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3   Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Razieh Sadat Tabatabaiee
4   Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Mojgan Karimi-Zarchi
4   Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Atiyeh Javaheri
4   Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Mahta Mazaheri
2   Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3   Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Elnaz Foroughi
5   Department of Pediatric Dentistry, Arak University of Medical Sciences, Arak, Iran
,
Rezvan Nasiri
5   Department of Pediatric Dentistry, Arak University of Medical Sciences, Arak, Iran
› Author Affiliations
Further Information

Publication History

01 February 2018

12 June 2018

Publication Date:
23 October 2018 (online)

Abstract

Objective Previous studies investigating the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and recurrent pregnancy loss (RPL) risk has provided inconsistent results. The aim of our study was to assess the association between the ACE I/D polymorphism and risk of RPL.

Methods All studies published up to January 30, 2018 on the association of ACE I/D polymorphism with RPL were identified by searching the PubMed, Web of Knowledge, and Google scholar databases.

Results A total of 26 case-control studies with 3,140 RPL cases and 3,370 controls were included in the meta-analysis. Overall, there was a significant association between ACE I/D polymorphism and RPL risk under the allele model (I versus D: odds ratio [OR] = 0.538, 95% confidence interval [CI] = 0.451–0.643, p ≤ 0.001), the homozygote model (II versus DD: OR = 0.766, 95% CI = 0.598–0.981, p = 0.035) and the recessive model (II versus ID + DD: OR = 0.809, 95% CI = 0.658–0.994, p = 0.044). Subgroup analysis by ethnicity showed that there was a significant association between ACE I/D polymorphism and increased risk of RPL in Caucasian and West-Asian populations, but not in East-Asians. When stratified by number of recurrent miscarriages (RMs), a significant association between ACE I/D polymorphism and increased risk of RPL was detected in the group of studies with ≥ 2 RMs, but not in studies with ≥ 3 RMs.

Conclusion The meta-analysis suggests that ACE I/D polymorphism is associated with increased risk of RPL. The ACE I/D polymorphism may be a risk factor for RPL in Caucasian and West-Asian populations, but not in East-Asians.

 
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