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Meta-Analysis of the Association between Plasminogen Activator Inhibitor-1 4G/5G Polymorphism and Recurrent Pregnancy Loss

Xuejiao Li, Yukun Liu, Rui Zhang, Jianping Tan, Libin Chen, Yinglin Liu

Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)

Med Sci Monit 2015; 21:1051-1056

DOI: 10.12659/MSM.892898

Available online:

Published: 2015-04-11

Background: The association between plasminogen activator inhibitor-1 (PAI-1) 4G/5G polymorphism and recurrent pregnancy loss (RPL) risk is still contradictory. We thus performed a meta-analysis.
Material and Methods: Relevant studies were searched for in PubMed, Web of Science, Embase, and Cochrane Library. An odds ratio (OR) with a 95% confidence interval (CI) was used to assess the association between PAI-1 4G/5G polymorphism and RPL risk.
Results: A total of 22 studies with 4306 cases and 3076 controls were included in this meta-analysis. We found that PAI-1 4G/5G polymorphism was significantly associated with an increased RPL risk (OR=1.89; 95% CI 1.34–2.67; P=0.0003). In the subgroup analysis by race, PAI-1 4G/5G polymorphism was significantly associated with an increased RPL risk in Caucasians (OR=2.23; 95% CI 1.44–3.46; P=0.0003). However, no significant association was observed in Asians (OR=1.47; 95% CI 0.84–2.59; P=0.18).
Conclusions: In conclusion, this meta-analysis suggests that PAI-1 4G/5G polymorphism might be associated with RPL development in Caucasians.

Keywords: Abortion, Habitual - genetics, Genetic Association Studies, Genetic Predisposition to Disease, Plasminogen Activator Inhibitor 1 - genetics, Polymorphism, Single Nucleotide - genetics, Pregnancy, Publication Bias, Risk Factors