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Association between Serum TNF ‐α Levels and Recurrent Spontaneous Miscarriage: A Meta‐analysis
Author(s) -
Zhang Chengdong,
Deng Xiaozhen,
Zhang Xuerong,
Pan Zhengyan,
Zhao Wei,
Zhang Yuening,
Li Jiatong,
Xiao Feifan,
Wu Huayu,
Tan Hezhang,
Guo Peifen,
Yang Xiaoli
Publication year - 2016
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12447
Subject(s) - meta analysis , confidence interval , medicine , strictly standardized mean difference , observational study , miscarriage , recurrent miscarriage , gastroenterology , pregnancy , biology , genetics
Most recurrent spontaneous miscarriages ( RSM s) are attributed to ‘unexplained’ factors, the majority of which are immune factors. Furthermore, clinically, only a small number of RSM patients get early diagnosis by testing for antiphospholipid antibodies, whereas most of the patients, present no specific diagnostic indicators. We performed a meta‐analysis of observational studies to detect the association between RSM and TNF ‐α levels. We searched PubMed, EMB ase, ScienceDirect, Web of Science, and Chinese databases (including: Wanfang Data, CNKI , and VIP databases) for articles published up to 2014. Of the 151 initially identified studies, 11 case–control studies with 1371 patients were finally analyzed. Overall, baseline TNF ‐α levels were higher in patients than in controls. The standardized mean difference of the TNF ‐α levels of the patients was 2.82 units (95% confidence interval 1.57–4.06) and the overall effect z ‐score was 4.42 ( P < 0.0001). The heterogeneity test revealed significant differences among individual studies ( P = 0.000, I 2 = 98.7%). Serum TNF ‐α levels were significantly increased in patients relative to those in controls. The heterogeneity could be attributed to the differences in the detection methods and sampling times used in the different studies.