Comprehensive assessment of the hemostatic system in women with РAI-1 gene polymorphism and first trimester pregnancy loss

Aim - to study the associations between hemostatic system parameters, natural anticoagulant levels and serum PAI-1 levels depending on the PAI-1 polymorphism variant in women with early reproductive losses. Materials and methods. The selected patients (n=115) were divided into 3 groups according to the type of polymorphism: Clinical group I (n=20) - patients with wild-type polymorphism of the РAI-1 gene (675 5G>5G), group II (n=53) - women with heterozygous polymorphism of the РAI-1 gene (675 5G>4G), group III (n=42) - women with homozygous pathological polymorphism of РAI-1 (675 4G>4G). The study was based on bibliosemantic analysis; anamnestic data were evaluated; polymerase chain reaction (PCR) was used to determine thrombophilia gene polymorphisms; enzyme-linked immunosorbent assay (ELISA) to determine the level of РAI-1 in the blood serum; clotting method to determine the levels of natural anticoagulants; coagulometric method to determine the level of fibrinogen and coagulation parameters. Results. The average age of women in the thematic groups was comparable and amounted to 32.5±0.9, 33.9±0.7 and 33.6±0.7 years, respectively. The analysis of associations in the comprehensive assessment of haemostatic parameters revealed certain associations between these parameters and a complicated obstetric history (spontaneous abortion, fetal growth retardation and pre-eclampsia, pregnancy loss in early (more frequent) and late gestation), and the presence of РAI-1 gene polymorphism. No significant associations were found between the presence of the РAI-1 gene polymorphism and levels of natural anticoagulant activity. The level of РAI-1 depended on the type of polymorphism in this gene and was associated with termination of pregnancy before 12 weeks. Conclusions. Polymorphisms of the PAI-1 gene should be considered as one of the risk factors for habitual miscarriage. Overexpression of PAI-1 is associated with adverse pregnancy complications, and its level is an extremely promising marker for prognosis and treatment effectiveness. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.