الفهرس 
R ECURRENT P REGNANCY L OSS (Only 14 pages are availabe for public view
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Abstract
Background: Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown. Endocrine factors may account for 15 to 60 percent of RPL. Pre-gestational diabetes is associated with an elevated risk of pregnancy loss, but it is unclear whether subclinical glucose intolerance is associated with pregnancy loss or not, especially recurrent pregnancy loss (RPL).
Objective: comparing maternal serum fructosamine in patients with and without RPL to determine whether increase serum fructosamine is associated with RPL.
Patients and Methods: This case control study was conducted on Ain Shams University Maternity Hospital, antenatal care clinic and contraception clinic from December 2018 to August 2019. The population of this study was women with recurrent miscarriage attended Ain Shams University Maternity Hospital age 20-40 years with BMI > 30 kg/m2 with two or more unexplained pregnancy losses prior to 20 weeks’ gestation with no more than one live birth (cases). Women had at least one uncomplicated full-term delivery (control group) and all the husbands had a spermiogram within normal limits. Maternal serum was analyzed for fructosamine on quantitative spectrophotometry
Results: serum fructosamine was higher in women with RPL compared with controls. Comparative study between RPL group and control shows non-significant difference as regards age, BMI and residence. Serum fructosamine had no relation to BMI in RPL patients.
Conclusion: In our study, analysis of data revealed that serum fructosamine was increased in RPL group compared to control group. By using ROC-curve analysis, serum fructosamine level at a cutoff point (>231) predicted women with abortion event, with fair (76%) accuracy, sensitivity= 60% and specificity= 82% (p < 0.01). Thus, subclinical glucose intolerance may be associated with an increased risk of RPL. Spearman’s correlation analysis shows that; age and serum fructosamine had a highly significant positive correlation with RPLs however parity had a highly significant negative correlation with RPL. Multiple regression analysis shows that; after applying (backward method) and entering some predictor variables; the increase in serum fructosamine; had an independent effect on increasing RPLs. Logistic regression analysis shows that; after applying (backward method) and entering some predictor variables; the increase in serum fructosamine; had an independent effect on increasing the probability of abortion event.