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Review Paper | Genetics | Volume 15 Issue 8, August 2026 | Pages: 1817 - 1821 | India
Association Between Angiotensin-Converting Enzyme (ACE) Gene Insertion / Deletion Polymorphism and Recurrent Pregnancy Loss: A Systematic Review of Published Studies
Abstract: Recurrent pregnancy loss (RPL) is a multifactorial reproductive disorder in which genetic, vascular, endocrine, immune, and environmental factors may interact. Angiotensin-converting enzyme (ACE) is an important component of the renin-angiotensin system and contributes to vascular tone, endothelial function, fibrinolysis, and uteroplacental circulation. The ACE insertion/deletion (I/D) polymorphism has consequently been investigated as a possible genetic susceptibility factor for RPL, although individual studies have reported inconsistent findings. The present systematic review and meta-analysis synthesised 26 eligible case-control studies comprising 3,140 women with RPL and 3,370 healthy controls. Methodological quality was assessed using the Newcastle-Ottawa Scale. Associations were examined using odds ratios (ORs) with 95% confidence intervals (CIs) under five genetic models. Significant associations were observed under the allelic model (I vs. D: OR = 0.538, 95% CI = 0.451-0.643, p < .001), homozygous model (II vs. DD: OR = 0.766, 95% CI = 0.598-0.981, p = .035), and recessive model (II vs. ID + DD: OR = 0.809, 95% CI = 0.658-0.994, p = .044). The heterozygous and dominant models were not statistically significant. Subgroup analysis demonstrated significant associations among Caucasian and West-Asian populations, whereas no statistically significant association was observed among East-Asian populations. Heterogeneity was moderate to high across the five models, with I? values ranging from 55.47% to 80.49%. Sensitivity analyses indicated that the pooled estimates were stable, and funnel-plot inspection together with Egger's regression did not indicate statistically significant publication bias. The findings support an association between ACE I/D polymorphism and RPL while highlighting population differences and substantial between-study variability.
Keywords: ACE I/D polymorphism, recurrent pregnancy loss, genetic association, meta-analysis, renin-angiotensin system, genetic susceptibility
How to Cite?: Sadia Sadaf, Dr. Saptarshi Sen Gupta, "Association Between Angiotensin-Converting Enzyme (ACE) Gene Insertion / Deletion Polymorphism and Recurrent Pregnancy Loss: A Systematic Review of Published Studies", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 1817-1821, https://www.ijsr.net/getabstract.php?paperid=SR26826154659, DOI: https://dx.doi.org/10.21275/SR26826154659