Measurement of maternal serum amyloid A as a novel marker of preterm birth

Abstract

Objective

To study the association between maternal serum amyloid A (mSAA) levels and preterm birth (PTB).

Methods

This prospective observational nested case control study was conducted at Ain Shams University Maternity Hospital, Cairo, Egypt, between May 2017 and December 2017. The study recruited pregnant women at 26–34 weeks presented with threatened preterm labor (PTL). Women with PTB were included in cases group while control group included women who continued pregnancy and delivered at term. Serum samples were collected to measure mSAA levels. The main outcome of the study was the association between mSAA levels and PTB. Secondary outcomes included neonatal intensive care unit admissions and neonatal mortality.

Results

Fifty-eight women were included in the final analysis (29 in each group). Women with PTB had a statistically significant higher mSAA levels [5.1 (4.5–7.7) vs. 1.2 (0.0–2.5) mg/l, for cases and controls respectively, p < .001]. Higher mSAA levels were also observed among women whose babies were admitted to NICU, but there was no significant relation between mSAA level and neonatal death. A statistically significant negative correlation was found between mSAA and gestational age at delivery and neonatal birth weight. mSAA had an excellent value to predict PTB (AUC = 0.972 [95% CI, 0.891–0.998], p < .0001), fair value to predict admission to NICU and a poor value to predict neonatal death.

Conclusions

mSAA level was found to be elevated among women with threatened PTL who end with PTB; mSAA is a potentially useful predictive marker of PTB that warrant further study.

CLINICALTRIALS.GOV: NCT01639027

Keywords:

• Maternal serum amyloid A
• preterm birth
• preterm labor

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

• M. I. Ibrahim: Project development, Data management, Study design, Idea conception, Manuscript writing.

• M. I. Ellaithy: Idea conception, Data analysis, Study design, Manuscript editing.

• A. M. Hussein: Idea conception, Study design, Manuscript writing.

• M. M. Nematallah: Idea conception, Study design, Manuscript writing, Data collection, Protocol development.

• H. A. Allam: Idea conception, Study design, Manuscript writing.

• A. S. Abdelhamid: Idea conception, Study design, Manuscript writing, Data collection, Protocol development.

• R. M. Harara: Idea conception, Study design, Manuscript writing, Data collection, Protocol development.

• A. A. Riad: Idea conception, Study design, Manuscript writing, Data collection, Protocol development.

• Tarek A. Rafaat: Idea conception, Study design, Manuscript writing.

All the authors revised the manuscript for the important intellectual content; approved the final version of the manuscript; and are in agreement with all aspects of the work.