Frequency of ACE I/D and PAI-1 4G/5G Polymorphisms in Women with Recurrent Pregnancy Loss in Sudan

This study aimed to investigate the prevalence of ACE I/D and PAI-1 4G/5G polymorphisms in Sudanese women experiencing recurrent pregnancy loss (RPL), and to explore their possible relationship with this condition. A retrospective study was carried out at Omdurman Maternity Hospital in Sudan. The study involved 125 participants: 64 RPL cases (defined as women with a history of at least three unexplained spontaneous abortions) and 61 healthy controls with normal success pregnancies and. A 5 mL EDTA blood sample was taken from each participant, and demographic, personal, and family medical information was collected using a questionnaire. Genomic DNA was extracted from blood leukocytes utilizing the GF-1 Blood DNA Extraction Kit. The polymorphisms of the PAI-1 4G/5G and ACE I/D genes were examined through polymerase chain reaction (PCR). Data analysis was conducted employing SPSS version 24. The ACE I/D polymorphism was found to have a notable association with recurrent pregnancy loss (RPL), with the I/D and D/D genotypes linked to an increased risk (odds ratio 1.29). Although the 4G allele and the 4G/4G genotype showed statistical significance, they were more prevalent in the control group (2.8% and 45.9%, respectively) compared to the cases (6.2%, p < 0.001). Homozygosity for the D allele of ACE, when combined with the PAI-1 4G/4G genotype, significantly raised the likelihood of RPL (p < 0.001). Despite a higher occurrence of the 4G/4G genotype in controls (17% versus 44.7%), these findings suggest complex interactions with other genetic factors. Overall, the homozygous D allele of ACE and the PAI-1 4G/4G genotype are more frequently observed among Sudanese women suffering from recurrent miscarriage, highlighting the commonality of these genetic variations within this population.