الفهرس 
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Abstract
Women with pregnancy loss need empathy and understanding. Early pregnancy loss, especially when recurrent, is a traumatic experience, similar to that associated with stillbirth or neonatal death.
Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies. Studies on the etiology, evaluation, and management of RPL are often flawed.
Despite its discovery 100 years ago, vitamin D (VD) has emerged as one of the most controversial nutrients and prohormones of the 21st century. In the past few years, a growing interest in vitamin D has been observed in the biomedical literature due to evidences demonstrating a relevant relationship not only between regulation of calcium and phosphorus homeostasis, but also multiple disease states and low vitamin D status in the population . Recent findings suggested a significant implication of vitamin D in different physiologic processes, such as vascular health, immune function, metabolism, and placental function. Findings from observational studies show higher rates of preeclampsia, gestational diabetes, preterm birth, recurrent pregnancy loss, and bacterial vaginosis in women with low vitamin D levels.
The aim of the recurrent study was to assess the association between vitamin D status and recurrent pregnancy loss.
The current study was conducted at Ain shams University Maternity Hospital during the period between October 2020 and April 2021.
The selected patients fulfilled the following criteria :
▪ Maternal age from 20 to 30 years old
▪ Singleton Pregnant women (with non-viable fetus immediately after termination of pregnancy)
▪ First trimester gestational age with unexplained repeated pregnancy loss (2 or more PL).
▪ Patients who had normal routine workup investigations of recurrent abortion according to the protocol of the hospital, so no obvious cause of RPL.
And we excluded from the study:
▪ Patients with Congenital malformed uterus
▪ Evident cause of abortion as chromosomal abnormalities of the fetus, congenital infection
▪ Multiple fetal pregnancy, infertile patients, collagen disorders
▪ Incompetent cervix, uterine fibroid or malformation
▪ High risk pregnancy as hypertension, smokers, diabetes.
A blood sample was collected from cases and controls and frozen till reaching our target, then serum 25(OH) vitamin D was assayed by ELISA.
The outcomes were: To assess the association between vitamin D status and recurrent pregnancy loss and to measure the prevalence of vitamin D deficiency in women with RPL.
We considered that the 25(OH)D concentration measured in our case control study with predominantly first-trimester blood sampling was most representative for women who had miscarriages before 13 weeks of gestation.
Choosing matched controls was to decrease confounders so according demographic variables; there was a statistically insignificant difference between group A (RPL) and group B (Normal pregnancy) as regards the demographic research data of study subjects recruited, the mean age was 24.5±2.6 years, the mean BMI was 25.8±2.1 Kg/m2.
There was a statistically significant difference between group A (RPL) and group B (Normal pregnancy) as regard 25(OH)D level (p <0.001), mean was 11.9±3.2 ng/ml and 16.9±6.5 ng/ml respectively.
Vitamin D was significantly associated with recurrent pregnancy loss.