Introduction:
Many studies, since the 60’s, have endeavoured to
establish a relationship between recurrent pregnancy loss (RPL) and
acquired thrombophilia, namely lupus anticoagulant (LA), anti-cardiolipin (ACA)
and β2-glycoprotein-1 (β2-GP1) antibodies. However, there is still unconvincing
evidence to link the two identities (Preston et al, 1996). A meta-analysis of
31 studies (Rey et al, 2003) showed only a modest relationship between them. A
high prevalence of RPL among young Malaysian women warranted such a study.
Objective:
To determine the relationship between acquired
thrombophilia and RPL in young Malaysian women.
Methodology:
990 RPL-women, aged 20 to 40 years, were
investigated for the three immune antibodies by clot-based and ELISA methods.
The patients were free of abnormal clinical conditions which could cause RPL.
Results:
4.74% of the patients were positive for one of the
three immune-antibodies which coexisted in similar prevalence in the
positive-patients.
Conclusions:
The prevalence of LA, ACA and β2-GP1 in Malaysian
RPL-women is similar to that of 4-5%, as seen in other studies worldwide.
However, our contention is that there is the presence of a yet to be identified
causative agent(s) or a combination of numerous factors that is responsible for
the RPL, and the 3 immune antibodies being mere “red herrings”.