Abstract
Spontaneous abortion is a common complication in early pregnancy, with an incidence of around 20%. Ultrasound scan and measurement of human chorionic gonadotropin are used to identify patients at risk of spontaneous abortion; however, there is a clinical need to find new biomarkers to prospectively identify patients before the onset of clinical symptoms. Here, we aim to investigate potential biomarkers of spontaneous abortion taken in the first clinical appointment of pregnancy. A case–control study was conducted based on a prospectively collected cohort in which cases and controls were retrospectively stratified based on pregnancy outcome: normal healthy pregnancies (controls = 33) and pregnancies that ended in spontaneous abortion (cases = 10). We evaluated extracellular vesicles isolated by precipitation with ExoQuick™ and protein concentrations of tissue plasminogen activator, leptin, and adiponectin measured by ELISA. The extracellular vesicles showed the typical morphology and membrane proteins: CD63, Alix, and Flotilin-1. The size distributions of the isolated extracellular vesicles were 112 ± 27 and 118 ± 28 nm in diameter for controls and spontaneous abortion, respectively, and the total amount of extracellular vesicles did not show any difference between controls and the spontaneous abortion group. The tissue plasminogen activator showed a significant difference (p = 0.0004) between both groups, although neither adiponectin nor leptin revealed significant changes, indicating that women who had spontaneous abortions have significantly higher levels of tissue plasminogen activator than women who had normal pregnancies.
Highlights
Spontaneous abortion (SA) or miscarriage is defined as an unintended pregnancy loss before20 weeks of gestation [1] and is the most common complication in early pregnancy with an incidence of around 20% [1,2]
Since exosomes are regarded as potential tools to identify pregnancy-related disorders in early stages of pregnancy, and type plasminogen activator (tPA) and adipogenic markers are critical for normal pregnancy, we aim to investigate the association between plasma Extracellular vesicles (EVs) concentration and tPA, leptin and adiponectin concentrations, and the prospective occurrence of spontaneous abortion in a prospective cohort study
As expected from the matched criteria, there are no significant differences between controls and women who had spontaneous abortion, regarding maternal age and body mass index (BMI)
Summary
Spontaneous abortion (SA) or miscarriage is defined as an unintended pregnancy loss before20 weeks of gestation [1] and is the most common complication in early pregnancy with an incidence of around 20% [1,2]. Low concentrations of human chorionic gonadotropin (hCG) during early pregnancy are associated with spontaneous abortion and other adverse pregnancy outcomes [5,6], and recent research suggested that low concentrations of serum progesterone may distinguish a viable pregnancy from miscarriages or ectopic pregnancies [7,8]. Ultrasounds and both serum hCG and progesterone concentrations can, to some extent, identify women at risk of spontaneous abortion, additional biomarkers are needed to prospectively identify at-risk pregnancies before the onset of clinical symptoms
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