Maternal serum amyloid A level as a novel marker of primary unexplained recurrent early pregnancy loss

Objective: To assess maternal serum amyloid A (SAA) levels among women with primary unexplained recurrent early pregnancy loss (REPL). Methods: A prospective study was conducted among women with missed spontaneous abortion in the first trimester at Ain Shams University Maternity Hospital, Cairo, Egypt, between January 21 and December 25, 2014. Women with at least two consecutive primary unexplained REPLs and no previous live births were enrolled. A control group was formed of women with no history of REPL who had at least one previous uneventful pregnancy with no adverse outcomes. Serum samples were collected to measure SAA levels. The main outcome was the association between SAA and primary unexplained REPL. Results: Each group contained 96 participants. Median SAA level was significantly higher among women with REPL (50.0 mu g/mL, interquartile range 26.0-69.0) than among women in the control group (11.6 mu g/mL, interquartile range 6.2-15.5; P<0.001). The SAA level was an independent indicator of primary unexplained REPL, after adjusting for maternal age and gestational age (odds ratio 1.12, 95% confidence interval 1.06-1.19; P< 0.001). Conclusion: Elevated SAA levels found among women with primary unexplained REPL could represent a novel biomarker for this complication of pregnancy.