Abstract
Pregnancy loss affects approximately 20% of couples. The lack of a clear cause complicates half of all miscarriages. Early evidence indicates the maternal immune system and angiogenesis regulation are both key players in implantation success or failure. Therefore, this prospective study recruited women in the first trimester with known viable intrauterine pregnancy and measured blood levels of immune tolerance proteins galectin-9 (Gal-9) and interleukin (IL)-4, and angiogenesis proteins (vascular endothelial growth factors (VEGF) A, C, and D) between 5 and 9 weeks gestation. Plasma concentrations were compared between groups defined based on (a) pregnancy outcome and (b) maternal history of miscarriage, respectively. In total, 56 women were recruited with 10 experiencing a miscarriage or pregnancy loss in the 2nd or 3rd trimester and 11 having a maternal history or miscarriage. VEGF-C was significantly lower among women with a miscarriage or pregnancy loss. Gal-9 and VEGF-A concentrations were decreased in women with a prior miscarriage. Identification of early changes in maternal immune and angiogenic factors during pregnancy may be a tool to improve patient counseling on pregnancy loss risk and future interventions to reduce miscarriage in a subset of women.
Highlights
A positive pregnancy test can be a momentous occasion in a person’s life; in the United States alone, 20% of couples will experience a pregnancy loss, which can lead to long-term physical and psychological distress [1,2]
We rely on clinical symptoms of vaginal bleeding and cramping as well as trending human chorionic gonadotropin levels and early pregnancy transvaginal ultrasonography to determine an increased risk of pregnancy loss; these methods are often unclear in the early stages of a miscarriage and there is a need for more prognostic indicators for pregnancy viability
Three women recruited under IRB 13-008482 did not have vascular endothelial growth factor (VEGF)-A data
Summary
A positive pregnancy test can be a momentous occasion in a person’s life; in the United States alone, 20% of couples will experience a pregnancy loss, which can lead to long-term physical and psychological distress [1,2]. Women who have a miscarriage report feeling isolated, ashamed, and dissatisfied that their clinical care did not address their emotional well-being [3]. We rely on clinical symptoms of vaginal bleeding and cramping as well as trending human chorionic gonadotropin (hCG) levels and early pregnancy transvaginal ultrasonography to determine an increased risk of pregnancy loss; these methods are often unclear in the early stages of a miscarriage and there is a need for more prognostic indicators for pregnancy viability. Despite investigation into the fetal and maternal interactions at play during gestation, there is still a limited understanding of these complex interactions [6,7,8,9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
