Detection of Cytomegalovirus antibodies and immunological markers in cases of unexplained miscarriage: Revealing underlying factors in Iraqi women

Background and Aim: This study investigates the influence of Cytomegalovirus (CMV) antibodies, specifically CMV IgG and IgM, on the expression of CD34+ and HLA-F in the peripheral blood of pregnant women. The research aims to assess the association of these immunological markers with risk factors for unexplained spontaneous miscarriage, with a particular focus on maternal health challenges in regions like Iraq. Methods: A cross-sectional study conducted in Iraq, which consisted of 200 blood samples taken from 100 healthy pregnant women and 100 recent unexplained spontaneous miscarriage (USM) cases from two Iraqi hospitals, focusing on cases of USM and healthy pregnant women. It used ELISA for serological detection of CMV IgG and IgM and HLA-F and CD34 concentrations. Results: A moderate positive correlation with statistical significance (r = 0.490, P ≤ 0.0001) between the levels of CD34+ and the HLA-F in both groups. Furthermore, a significant statistical relationship was found between CD34+ (p ≤ 0.028) and HLA-F (p ≤ 0.017) levels and the presence of CMV IgG in the miscarried group. The results indicated a critical association (p ≤ 0.001) between immune factor concentrations and the incidence of unexplained spontaneous abortion. The levels of CD34+ and HLA-F were lower in women who experienced miscarriages, measured at (1.54±0.34) and (2.65±0.56) ng/ml. Furthermore, the study found a significant association between the number of miscarriages and lower HLA-F concentration in miscarriages. Conclusions: This study indicates a notable link between reduced expression of immune markers and the incidence of USM in women. Recurrent miscarriage, maternal age, and first trimester are also potentially associated risk factors. Further studies are needed to confirm the association with CMV IgG.