THE ASSOCIATION BETWEEN INSULIN RESISTANCE AND EARLY SPONTANEOUS MISCARRIAGES IN JOS - PLATEAU STATE
BACKGROUND: Recurrent spontaneous miscarriages (RSM) remain a major challenge to gynaecologists as 50% of aetiologies of spontaneous miscarriages are unknown. Insulin resistance (IR) has been implicated as an aetiological factor. However, there are insufficient and conflicting evidence regarding the contribution of insulin resistance to the occurrence of RSM.
OBJECTIVE: To investigate the relationship between insulin resistance and first trimester recurrent spontaneous miscarriages in comparison with first trimester normal pregnancies.
DESIGN: Case control study.
METHODOLOGY: This was a case-control study involving 80 women with first trimester RSM (cases) and 80 Women with normal first trimester pregnancies with at least one successful pregnancy and no history of miscarriages (Controls). From each participant fasting blood glucose (FG) was assayed by automated colorimetric enzymatic analysis and fasting insulin (FI) was assayed by BIOS Human insulin ELISA kits. Data was analysed using SPSS version 22.0.
RESULTS: There were no significant differences between the mean age and BMI of cases and controls (p= 0.990 and 0.930 respectively). FG was significantly higher in cases compared to controls, (4.77±1.14 vs 3.58±0.78)mmol/L, p<0.001, however no significant difference in FI between cases and controls, 26.62±14.62 vs 25.15±13.61mIU/L, p= 0.509. Prevalence of IR (HOMA-IR >4.5) and (FG/FI ratio <4.5) for cases and controls are 48.8% vs 27.5% and 63.8% vs 53.8% respectively. HOMA-IR >4.5 was statistically significant between cases and controls, p = 0.009.
CONCLUSION: This study suggests that women with recurrent first trimester miscarriages are more likely to be insulin resistant with higher fasting blood glucose levels compared to women with normal first trimester pregnancies.