Serum Amyloid A in Preeclampsia

Abstract

Background Preeclampsia is a common complication of pregnancy and remains a common cause of maternal and fetal mortality. The clinical symptoms of preeclampsia are caused by widespread endothelial dysfunction suggested to be a part of an exaggerated maternal inflammatory response to pregnancy. Since preeclampsia is associated with widespread endothelial dysfunction, proposed to be provoked by an increased maternal systemic inflammatory response, the maternal plasma level of SAA might be expected to be increased when compared to normal pregnancy levels. The maternal plasma level of SAA in normal pregnancy could differ from non-pregnant level due to increased hormone levels, increased adipose tissue and\or secondary to modifications of inflammatory response in normal pregnancy. Aims The aim of our study is to estimate the relation between serum amyloid A in pregnant women and preeclampsia. Methodology the study conducted this case control study in the emergency room of Ain Shams University Maternity Hospital starting from April 2018 on women with preeclampsia to estimate serum amyloid A in pregnant women with preeclampsia. Members of the control group are healthy, non-smoker pregnant women who had an uncomplicated antenatal course and all arterial blood pressure measurements were normal. Results The current study was conducted in Ain Shams University Maternity Hospital in the period between January 2017 and August 2018. A total of 75 women were included in the study. The process of recruitment and handling the study population during the course of the study is shown in the flow diagram (figure 1). In order to avoid any confounding effect for a possible subclinical ongoing pathophysiological process, four women with preeclampsia lacking severe features were excluded following the development of severe features shortly after measurement of serum amyloid A level. Conclusion Our data sustain the limited number of studies investigating the SAA levels in both preeclamptic and healthy pregnant women, in which it was hard to reach a consensus regarding the association between SAA levels and preeclampsia. Taken in consideration that an elevated plasma level of SAA in preeclamptic women should be considered pathologic, we believe that the response of relationship between the preeclampsia and SAA levels could be caused by an inflammatory condition associated with preeclampsia. Also, serum amyloid A can be used to discriminate between mild preeclampsia cases and controls and as discriminate between severe preeclampsia cases and controls. Recommendation We recommended further investigation on large sample size for the elucidation of the role of SAA in pre-eclampsia neonatal outcome and the possibility of these biochemical factors to be novel markers of such disorders in pregnant women.