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Association between factor V Leiden mutation and recurrent pregnancy loss in the middle east countries: a Newcastle–Ottawa meta-analysis

  • Maternal-Fetal Medicine
  • Published:
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Abstract

Purpose

Heritable thrombophilia is a category of genetic disorders of the coagulation cascade with the increasing risk of thrombus formation and recurrent pregnancy loss (RPL). Factor V Leiden (FVL) (R506Q) mutation is the most common genetic cause of deep venous thrombosis, but its association with RPL has been inconsistent in studies arising from non-Western countries. The present metanalysis was aimed to determine whether an association exists between FVL and RPL in the Middle East.

Methods

We searched PubMed, MEDLINE Web of Science, Scopus, and Embase, evaluating the association between the FVL and RPL. The Middle East countries (Bahrain, Cyprus, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, The State  of Palestine, Syria, Turkey, The United Arab Emirates, and Yemen) were evaluated in succession. Raw data were extracted, and 19 case–control studies were included in our final analysis.

Results

Overall, 2513 cases and 1836 controls in the Middle East showed a prevalence of FVL mutation as 12.6% and 4.9% in patients and controls, respectively. To evaluate the relationship between FVL mutation and RPL, we used Forest plot (random effect model) with the overall random OR of 2.37 (CI 95%: 1.50–3.75). FVL mutation was associated with a higher risk of RPL. In Iran, the OR was 1.90 (95% CI 1.04–3.45), and in Turkey, the OR was 3.01 (95% CI 1.10–8.23).

Conclusion

The results of our study support an association between FVL mutation status and RPL in women of the Middle East countries. It is recommended that specific policies include comprehensive testing for FVL mutation as a standard of care in women of the Middle East region with unexplained RPL.

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Funding

 Dr. C. Sergi's research has been funded by the generosity of the Stollery Children’s Hospital Foundation and supporters of the Lois Hole Hospital for Women through the Women and Children’s Health Research Institute, Hubei Province Natural Science Funding for Hubei University of Technology (100-Talent Grant for Recruitment Program of Foreign Experts Total Funding: Digital PCR and NGS-based diagnosis for infection and oncology, 2017-2022), Österreichische Krebshilfe Tyrol (Krebsgesellschaft Tirol, Austrian Tyrolean Cancer Research Institute, 2008), Austrian Research Fund (Fonds zur Förderung der wissenschaftlichen Forschung), Canadian Foundation for Women's Health, Cancer Research Society, Canadian Institutes of Health Research, and the Saudi Cultural Bureau, Ottawa, Canada. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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  1. Department of Laboratory Medicine and Pathology, University of Alberta, WMC 5B4.09, 8440 112 ST NW, Edmonton, AB, Canada

    Bahareh Hamedi, Joseph Feulefack, Aiza Khan & Consolato Sergi

  2. Department of Oncology, University of Alberta, Edmonton, AB, Canada

    Bahareh Hamedi

  3. Department of Pediatrics, University of Alberta, Stollery Children’s Hospital, Edmonton, AB, Canada

    Consolato Sergi

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BH conceptualized the study, collected data, drafted the initial manuscript, and revised the manuscript. JF performed the meta-analysis, AK revised the data and performed the Quality Control check, CS designed the study, was responsible for the intramural funding, and revised the manuscript. All authors meet the ICMJE requirements for authorship, approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Consolato Sergi.

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Comprehensive Meta-Analysis, Biostat, Englewood, NJ, USA.

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Hamedi, B., Feulefack, J., Khan, A. et al. Association between factor V Leiden mutation and recurrent pregnancy loss in the middle east countries: a Newcastle–Ottawa meta-analysis. Arch Gynecol Obstet 302, 345–354 (2020). https://doi.org/10.1007/s00404-020-05610-6

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