(356) The Relationship between the Plasminogen Activator Inhibitor-1 (PAI-1) Polymorphism and Adverse Obstetrical Outcomes

Objective: The purpose of this study is to investigate the characteristic differences in PAI-1 polymorphism status in a population of patients with RPL and/or adverse obstetrical outcomes.

Study Design: An IRB-approved retrospective chart review of patients who sought care at the Hackensack University Medical Center MFM Division and underwent testing for the PAI-1 polymorphism between January 1, 2019 and January 1, 2024 was performed. Included patients were those that had a history of 2 or more pregnancy losses, and/or adverse obstetrical outcomes, such as fetal growth restriction, intrauterine fetal demise, postpartum hemorrhage, placental abruption, preterm labor / PPROM associated with the thrombin pathway, or preeclampsia with severe features. Patient characteristics and pregnancy outcomes were recorded in REDCap. Chi-square goodness-of-fit test was performed.

Results: 132 patients who met inclusion criteria were identified. 18 patients (13.6%) had the PAI-1 4G/4G polymorphism present, 69 patients (52.3%) had the 4G/5G polymorphism present, and 45 patients (34.1%) had the 5G/5G polymorphism present. There was no significant difference between the observed and expected distribution of PAI-1 polymorphisms in patients with recurrent pregnancy loss, nor was there a significant difference in patients who had second trimester pregnancy losses. In patients with placental abruption, there was a statistically significant difference in the observed distribution of PAI-1 polymorphisms compared to expected (X2 (2, N = 13) = 6.286, p < 0.0432), with the PAI-1 5G/5G polymorphism occurring in 61.5% of patients with placental abruption. However, there was no statistically significant difference in PAI-1 polymorphism status in patients with any of the other studied adverse obstetrical outcomes.

Conclusion: In patients with placental abruption, there was a higher distribution of patients with the PAI-1 5G/5G polymorphism than expected. However no significant difference in distribution was noted in patients with recurrent pregnancy loss or other studied adverse obstetrical outcomes.