Glucose metabolism tests and recurrent pregnancy loss: evidence from a systematic review and meta-analysis

Abstract

Abstract Objective To synthesize the published citations to determine the association between glucose metabolism tests and recurrent pregnancy loss (RPL). Method The electronic databases including PubMed, Scopus and Web of Science were searched for the original articles that evaluated the correlation between glucose metabolism tests including fasting blood glucose (FBG), fasting insulin (FI), homeostatic model assessment for insulin resistance (HOMA-IR), the rate of individuals with HOMA-IR  > 4.5, insulin resistance, fasting glucose/fasting insulin (FG/FI) and FG/FI  > 4.5.and recurrent pregnancy loss with a combination of proper keywords. Results The database search led to finding 390 articles. Detailed screening of titles and abstracts for potential eligibility was performed, and after excluding the duplicated and irrelevant citations, finally, 8 studies were selected to be included in this study, 7 observational studies and one controlled clinical trial. A significant difference in the amount of FI, HOMA-IR, the rate of HOMA-IR  > 4.5, the rate of individuals with insulin resistance, fasting glucose/fasting insulin (FG/FI), and the rate of FG/FI  > 4.5 were found among RPL patients compared to controls. There was no difference when comparing FBG between the groups. Conclusion This study indicates an important link between abnormal glucose metabolism tests and a history of recurrent pregnancy loss. These data may encourage clinicians to request glucose metabolism tests other than FBG in women with recurrent pregnancy loss.