Abstract
The causes of recurrent spontaneous abortion (RSA) are highly complex. A comprehensive analysis of the risk factors for RSA will be beneficial for its diagnosis and treatment. Peripheral blood from RSA patients were collected to test the levels of autoantibodies, thyroid antibodies, anticoagulant proteins, and lupus-anticoagulants. Then, 3 major electronic databases (PubMed, China National Knowledge Infrastructure, and Cochrane Library) were searched to include all detection indicators related to RSA. First, we found that 6 autoantibodies were significantly elevated in RSA patients. Among these, antinuclear antibody (RSA: 32.99 ± 3.85; control group: 13.51 ± 3.30, P < .001, R = 0.612) showed the highest correlation with RSA. Additionally, the expression levels of anti-double-stranded DNA antibody-IgG antibody (R = 0.306) and anti-RA33 IgG antibody (R = 0.265) were also highly correlated with RSA. The protein S activity in RSA patients was significantly lower than in the control group. The ratios of lupus-anticoagulants, thyroid peroxidase antibodies, and thyroglobulin antibodies were significantly higher in RSA patients. Then, the meta-analysis revealed that the levels of antinuclear antibody, thyroid peroxidase antibody, anticardiolipid antibody, lupus anticoagulant, DFI, and BMI were significantly elevated in RSA patients, while the activity of protein S and protein C were decreased. Finally, there were no statistically significant differences in the expression levels of these indicators between patients with 2 and 3 miscarriage histories. Given the complexity of the causes of RSA, early multi-indicator combined testing for patients with a history of ≥2 miscarriages can effectively improve the accuracy of diagnosing RSA. This approach can optimize treatment plans and improve the prognosis for patients with RSA.