association of plasminogen activator inhibitor-1 (pai-1) and angiotensin converting enzyme polymorphisms with recurrent pregnancy loss in iranian women

background: recurrent pregnancy loss (rpl) defined by two or more failed pregnancies before 20 weeks of gestation. several factors play a role in rpl including thrombophilic conditions which can be influenced by gene polymorphisms. plasminogen activator inhibitor-1 (pai-1) and angiotensin converting enzyme (ace) genes are closely related to fibrinolytic process, embryonic development and pregnancy success. objective: the aim of this study was to investigate the relationship between rpl and common polymorphisms in ace and pai-1 genes. materials and methods: in this case control study, 100 women with recurrent abortions (at least two) were selected as cases and 100 healthy women with two or more normal term deliveries without a history of abortion as controls. total genomic dna was isolated from blood leukocytes. the status of the pai-1 4g/5g and ace (d/i) polymorphism was determined by pcr-rflp. results: homozygosity for pai-1 4g polymorphism was seen in 17 cases (17%), and 5 controls (5%) (p=0.006) so patients with homozygote 4g mutation were significantly more prone to rpl in contrast to control group (or: 4.63, % 95 ci: 1.55-13.84). in addition, 7 patients (7 %), and no one from the control group, were homozygote (i/i) for ace polymorphism (p=0.034), suggesting no significant associations between ace d allele or dd genotype and rpl. conclusion: considering these results, because 4g/4g polymorphism for pai-1 gene could be a thrombophilic variant leading to abortion, analysis of this mutation and other susceptibility factors are recommended in patients with rpl.