Abstract
Objectives
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, and 34 weeks gestation and in cord
blood, and maternal uterine artery Doppler resistance index (RI) at ≥10 weeks gestation.
Results
Relaxin rose to a peak at 12 weeks, and gradually declined towards term. At all gestations,
women with a history of RPL had lower RLX levels than women without. At 10–12 weeks
gestation, uterine artery RI correlated with serum RLX for both RPL and NRPL. In the
NRPL group at 10–12 weeks the presence of a notched waveform was associated with higher
RLX levels than the absence of a notch (mean 2.1 ng/ml vs. 1.3 ng/ml, P < 0.05) and also at 20 weeks (2.1 ng/ml vs. 0.95 ng/ml, P < 0.05) but no such difference was seen 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.
Keywords
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Article info
Publication history
Published online: August 12, 2009
Accepted:
July 21,
2009
Received in revised form:
May 22,
2009
Received:
February 12,
2009
Identification
Copyright
© 2009 Published by Elsevier Inc. All rights reserved.
