Association of VEGF and p53 Polymorphisms and Spiral Artery Remodelling in Recurrent Pregnancy Loss: A Systematic Review and Meta-analysis.

Many studies have reported the association of VEGF-1154G/A, VEGF 936C/T and p53 Arg72Pro polymorphisms with Recurrent Pregnancy Loss (RPL), but the outcomes are inconsistent. We have used meta-analysis to associate these polymorphisms with RPL, having the spiral artery remodelling as a major risk factor. The studies were identified from three different reputed databases, namely Science direct, PubMed/Medline and Scopus. The eligible studies of VEGF-1154G/A, VEGF 936C/T and p53Arg72Pro polymorphisms associated with the RPL were selected for the analysis. They were segregated into three different ethnic groups as Asians, Caucasians and mixed population. For the analysis, the overall prevalence, Odds ratio, Risk ratio, Relative risk ratio and P values were calculated. A total of 3241 RPL cases and 3205 healthy controls from 21 different case-control studies were analysed. RPL was highly prevalent in mixed population with VEGF-1154G/A and p53 Arg72Pro polymorphisms (70.04% and 66.46% respectively) and in Asian population with VEGF 936C/T polymorphism (53.58%). The homozygous recessive genotypes of VEGF and p53 exhibited significant association between the respective polymorphisms and RPL along with the increased risk of outcome. The current analysis conclusively reports the geographic distribution of the different genetic polymorphisms which shows high association with the progression of RPL. Understanding the spectrum of polymorphisms on different population with the spiral artery remodelling as a risk factor encloses the importance of the vasculature during the pregnancy.