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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, D.O.C., El Gelany, S., Elliott, S. and Li, T.C. (2009) 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. European Journal of Obstetrics and Gynecology and Reproductive Biology, 147 (1). pp. 41-45. ISSN 0301-2115

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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. Crown Copyright (C) 2009 Published by Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Copyright, Publisher and Additional Information: © 2009 Elsevier. This is an author produced version of a paper subsequently published in European Journal of Obstetrics and Gynecology and Reproductive Biology. Uploaded in accordance with the publisher's self-archiving policy.
Keywords: Relaxin; Pregnancy; Recurrent miscarriage; Doppler; Implantation
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield) > Clinical Sciences Division South (Sheffield) > Reproductive and Developmental Medicine (Sheffield)
Depositing User: Miss Anthea Tucker
Date Deposited: 02 Dec 2009 15:53
Last Modified: 08 Feb 2013 16:59
Published Version: http://dx.doi.org/10.1016/j.ejogrb.2009.07.008
Status: Published
Publisher: Elsevier
Refereed: Yes
Identification Number: 10.1016/j.ejogrb.2009.07.008
URI: http://eprints.whiterose.ac.uk/id/eprint/10222

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