Thrombophilia investigation in Pakistani women with recurrent pregnancy loss


  • Nazli Hossain: conceived the idea, secured funding, carried on original work and wrote the manuscript; Tahir Shamsi: co-investigator, helped in grant and manuscript writing; Nazeer Khan: statistical analysis and helped in manuscript writing; Arshi Naz: responsible for laboratory analysis and helped in manuscript writing.

  • All laboratory analysis was done at the National Institute of Blood Diseases, Karachi, Pakistan.

Dr Nazli Hossain, Department of Obstetrics and Gynecology Unit 2, Dow University of Health Sciences, Baba-E-Urdu Road, Karachi 74200, Pakistan. Email:


Aim:  The aim of the study was to identify thrombophilic defects in women with a history of recurrent miscarriage.

Methods:  This was a case-control study in which the cases were women who had undergone spontaneous recurrent pregnancy losses and the controls were women in matched reproductive age groups without any history of miscarriage or pregnancy loss. Both groups of women were identified from our department's high-risk and gynecological outpatient clinics. A total of 52 women with recurrent pregnancy losses and 268 controls were tested for protein C, protein S, factor V Leiden (FVL), antithrombin and anticardiolipin (immunoglobulin M and G) antibodies, and the odds ratio and P-values were calculated.

Results:  The mean age was 28.0 ± 4.4 years in the cases and 32.0 ± 8.0 years in the controls. The mean number of abortions among women with recurrent losses was 3.40 ± 1.23. The mean parity was 1.04 ± 1.23 (range 1–6), and 3.27 ± 2.51 among controls. Among women with recurrent pregnancy loss, 22 (42%) had first trimester losses, 19 (36%) had second trimester losses, and 11 (21%) women had both first and second trimester losses. Protein C deficiency was identified in three out of 52 cases and 18 out of 268 controls (P-value 0.49), protein S deficiency in two cases and 12 controls (P-value 0.35), factor V Leiden mutation in 10 cases and 27 controls (P = 0.059), antithrombin in one case and 41 controls (P = 0.009), and anticardiolipin antibodies in one case and nine controls (P = 0.49).

Conclusion:  No significant association between inherited thrombophilia and recurrent pregnancy loss in Pakistani women was found.