Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss

Craig, LaTasha B.; Ke, Raymond W.; Kutteh, William H.

doi:10.1016/s0015-0282(02)03247-8

Cited by 151 publications

(94 citation statements)

References 16 publications

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“…A recent study suggested that insulin resistance is an independent risk factor for early pregnancy loss in all women 17 , and another that hyperinsulinemia is also an independent risk factor for recurrent pregnancy loss in normal women 44 . This raises the question of whether pregnancy loss in PCOS may be due to insulin resistance.…”

Section: Insulin Resistancementioning

confidence: 99%

The Pathophysiology of Miscarriage in Women with Polycystic Ovary Syndrome. Review and Proposed Hypothesis of Mechanisms Involved

Essah¹,

Cheang²,

Nestler³

2004

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Section: Insulin Resistancementioning

confidence: 99%

The Pathophysiology of Miscarriage in Women with Polycystic Ovary Syndrome. Review and Proposed Hypothesis of Mechanisms Involved

Essah¹,

Cheang²,

Nestler³

2004

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“…Although no cause is found in the majority of cases, it has been associated with the antiphospholipid syndromes (1), immunological "intolerance" from altered function of endometrial natural killer (NK) cells (2), the polycystic ovary syndrome (3) and insulin resistance (4). A common mechanism for fetal wastage in RPL is defective implantation.…”

Section: Introductionmentioning

confidence: 99%

Serum relaxin levels are reduced in pregnant women with a history of recurrent miscarriage, and correlate with maternal uterine artery Doppler indices in first trimester

Anumba

Gelany

Elliott

et al. 2009

European Journal of Obstetrics & Gynecology and Reproductiv

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CondensationSerum relaxin levels are reduced in pregnant women with a history of recurrent miscarriage, and correlate with maternal uterine artery Doppler indices in first trimester. 3 ABSTRACTObjectives: Defective implantation is a mechanism for recurrent pregnancy loss (RPL). We sought to determine whether the serum expression of human relaxin 2 (RLX) is impaired in women with a history of RPL.Study Design: Employing a prospective case-controlled design we studied 20 pregnant women with a history of RPL and 20 age-matched women with no history of RPL (NRPL). We measured serum relaxin 2 levels by ELISA at 6-8, 10-12, 20, 34 wks gestation and in cord blood, and maternal uterine artery Doppler resistance index (RI) at ≥ 10 wks gestation.Results: Relaxin rose to a peak at 12 wks, and gradually declined towards term. At all gestations, women with a history of RPL had lower RLX levels than women without. At 10-12 wks uterine artery, uterine artery RI correlated with serum RLX for both RPL and NRPL and the presence of a notched waveform in the NRPL group was associated with higher RLX levels than the absence of a notch (mean 2.1 vs.1.3ng/ml, P < 0.05 respectively), and also at 20 wks (2.1 vs. 0.95 ng/ml, P < 0.05 respectively), but did not differ in the RPL group. Umbilical venous RLX was 4-fold higher in the RPL group than the NRPL group. Conclusion.Women with a history of RPL demonstrate attenuated levels of serum RLX across all pregnancy trimesters. How dysregulated RLX metabolism may contribute to adverse pregnancy outcome in RPL requires further investigation.

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“…30 Insulin resistance is often associated with a hypercoagulable state (impaired fibrinolysis) and increased inflammatory cytokine levels. 31 Insulin resistance has been demonstrated to increase expression of PAI-1. PAI-1 activity is known to elevate levels of serum insulin and it induces a hypo fibrinolytic state.…”

mentioning

confidence: 99%

Relationship of insulin resistance with recurrent pregnancy loss

Wani

Gul

Jabeen

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: The recurrent pregnancy loss (RPL) is defined as two and more failed pregnancies as documented by ultrasound and histopathological examination and suggested some assessment after each loss with a thorough evaluation after three or more losses. RPL is one of the most frustrating and difficult areas in reproductive medicine because the aetiology is often unknown and there are few evidence based diagnostic and treatment strategies.Methods: 150 Non pregnant females were taken as both cases and controls in the study. All the pregnancy losses were documented by ultrasound or histological examination after uterine curettage. The control group consisted of women with no RPL with at least one live birth. These two groups were matched on the basis of age and BMI. All the women underwent following examinations, viz. Hysterosalpingography, karyotype of both partners, serum TSH, FT4, prolactin and antibodies for APLA. In addition blood sample were taken for fasting serum glucose and serum insulin level later insulin resistance was calculate using three parameters Fasting insulin > 20IU/ml. Diagnostic of Insulin Resistance. (2) Fasting glucose / Fasting insulin. A ratio of < 4.5 being diagnostic of insulin resistance. (3) HOMA IR. FG (mg/dl) x FPI (IU/ml) FG (mmol/l) x FPI (IU/ml)------------------------------------ OR ----------------------------------- 405 22.5Where 1 mmol/l = 18mg/dl, A value of > 4.5 being diagnostic of insulin resistance.Results: 150 patients were enrolled in this study among which 75 were selected as cases and 75 as controls after fulfilling inclusion and exclusion criteria with mean age cases group was28.4+2.37 years and 29.1+2.70 years in control group mean miscarriage rate in study group was 3.17+83 and control group with 0.35+0.48 with statistically significant difference. Mean fasting glucose (96.5+ 7.86) mg/dl, Fasting Insulin (14.1±5.91) IU/ml. Mean Glucose Insulin ratio (8.1±3.39), HOMA-IR (3.4 ±1.51) in the study group and in control group mean fasting glucose was (87.1+11.49) mg/dl, Fasting Insulin (6.9 ± 4.99) IU/ml. Mean Glucose Insulin ratio (17.8 ±11.44), HOMA-IR (1.5 ±1.27) respectively with statistically significant difference.Conclusions: In women with recurrent pregnancy loss fasting insulin and insulin resistance are higher than those in women without spontaneous abortion. The most sensitive parameter for calculating insulin resistance was found to be fasting insulin followed by HOMA – IR and followed by fasting glucose/fasting insulin ratio. It is therefore important to recommend a fasting insulin and fasting glucose level while evaluating a case of recurrent pregnancy loss to assess for insulin resistance.

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Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss

Cited by 151 publications

References 16 publications

The Pathophysiology of Miscarriage in Women with Polycystic Ovary Syndrome. Review and Proposed Hypothesis of Mechanisms Involved

The Pathophysiology of Miscarriage in Women with Polycystic Ovary Syndrome. Review and Proposed Hypothesis of Mechanisms Involved

Serum relaxin levels are reduced in pregnant women with a history of recurrent miscarriage, and correlate with maternal uterine artery Doppler indices in first trimester

Relationship of insulin resistance with recurrent pregnancy loss

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