Most recurrent spontaneous miscarriages (RSMs) 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-alpha levels. We searched PubMed, EMBase, 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-alpha levels were higher in patients than in controls. The standardized mean difference of the TNF-alpha 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-alpha 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.
[1]Guangxi Med Univ, Med Sci Res Ctr, 22 Shuangyong Rd, Nanning 530021, Guangxi, Peoples R China.
[2]Fudan Univ, Sch Life Sci, Dept Microbiol & Microbial Engn, Shanghai 200433, Peoples R China.
[3]Guangxi Med Univ, Clin Acad 1, Nanning 530021, Guangxi, Peoples R China.
[4]Guangxi Med Univ, Dept Pathophysiol, Nanning 530021, Guangxi, Peoples R China.
[5]Guangxi Med Univ, Dept Cell Biol & Genet, Sch Preclin Med, Nanning 530021, Guangxi, Peoples R China.
[6]Guangxi Med Univ, Affiliated Hosp 4, Dept Nephrol, Liuzhou, Peoples R China.
[7]Chinese Peoples Armed Police Force, Dept Obstet & Gynaecol, GuangDong Prov Hosp, Guangzhou, Guangdong, Peoples R China.
(8.0+极速模式)