South Asian Research Journal of Biology and Applied Biosciences (SARJBAB)
Volume-8 | Issue-03
Original Research Article
Association of ACE Insertion/Deletion Polymorphism with Recurrent Miscarriage among Iraqi Women: A Preliminary Case-Control Study
Rashad Imad Al-Zamili, Mohanad Jawad, Rahma Majid Al-Allawi
Published : June 3, 2026
Abstract
Background: Recurrent Miscarriage (RM) or Recurrent Pregnancy Loss is a complex reproductive issue that can be influenced by multiple risk factors including; Genetic, Anatomical, Endocrine, Immune System Thrombotic and Environmental factors. As such, the Angiotensin-Converting Enzyme (ACE) Insertion/Deletion (I/D) Polymorphism in Intron 16 has been considered as one of the possible genetic risk factors for RM because the D allele is associated with increased ACE Activity and could affect blood vessel constriction, Placenta Blood Flow and Pathways related to Thrombosis. Objective: To assess if there is an association between the ACE I/D genetic polymorphism and RM in a group of Iraqi women. Methods: Samples of EDTA blood were collected from women who had experienced RM but had been sent to have their thrombophilias assessed and from women who did not have a history of RM. Peripheral blood genomic DNA was isolated. Following DNA quality assessments, we genotyped for the ACE I/D genetic polymorphism by PCR using 14 RM samples and 8 control samples. The D allele was identified by a 190 bp product and the I allele by a 490 bp product. The Chi-Square/Fisher Exact test was used to compare genotype and allele frequencies. Results: The DD, ID and II genotypes were observed in 9/14 (64.3%), 5/14 (35.7%) and 0/14 (0.0%) RM cases, respectively, compared with 2/8 (25.0%), 4/8 (50.0%) and 2/8 (25.0%) controls. The genotype distribution showed a trend toward difference between groups (chi-square = 5.33, p = 0.070). In an exploratory dominant-risk comparison, the DD genotype was more frequent in RM cases than controls (OR = 5.40, 95% CI = 0.78-37.50; Fisher exact p = 0.183). The D allele frequency was higher in RM cases than controls (82.1% vs. 50.0%; OR = 4.60, 95% CI = 1.16-18.23; Fisher exact p = 0.040). Conclusion: The ACE D allele and DD genotype were more frequent among Iraqi women with RM in this preliminary dataset. However, because the effective genotyped sample was small, these findings should be interpreted cautiously and validated in a larger, clinically well-characterized Iraqi cohort.