Serum amyloid-a may be an early marker in diagnosis of preterm premature rupture of membrane and chorioamnionitis

Kayabas, Hatice; Bıldırcın, Fatma Devran; Avcı, Bahattin; Karli, P; Özdemir, Ayşe; Alper, Tayfun

doi:10.5455/annalsmedres.2019.11.751

Cited by 3 publications

(8 citation statements)

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“…We also found that SAA1 levels were markedly increased in maternal circulation in preterm birth with chorioamnionitis when compared with gestational age-matched iatrogenic preterm birth (40). In addition to the rise of SAA levels in maternal circulation, SAA levels in cord blood were also significantly higher in patients with PPROM (115 µg/mL) than in patients without PPROM (26 µg/mL) (77). These results suggest that both mother and fetus may respond to PPROM, and the response may be particularly strong when chorioamnionitis is present.…”

Section: Pprom and Chorioamnionitissupporting

confidence: 54%

“…Yang et al found that SAA 1 and 2 were among the proteins which were significantly elevated in maternal blood in lipopolysaccharide (LPS)-induced preterm birth in the mouse (75). In human studies, Koseoglu et al found that SAA levels in maternal blood were significantly elevated in the PPROM group compared to the control group (76), and Kayabas et al demonstrated that SAA levels in maternal circulation were further increased in patients with clinical chorioamnionitis (107 µg/mL) when compared with patients with only PPROM but not chorioamnionitis (21 µg/mL) (77). We also found that SAA1 levels were markedly increased in maternal circulation in preterm birth with chorioamnionitis when compared with gestational age-matched iatrogenic preterm birth (40).…”

Section: Pprom and Chorioamnionitismentioning

confidence: 99%

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Serum amyloid A, a host-derived DAMP in pregnancy?

et al. 2022

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Serum amyloid A (SAA) is one of the acute phase proteins released primarily from the liver in response to infection, inflammation and trauma. Emerging evidence indicates that SAA may function as a host-derived damage-associated molecular pattern (DAMP) protein to sense danger signals in pregnancy. The plasma SAA levels in maternal circulation are significantly increased in normal parturition, particularly in postpartum, as well as in gestational disorders such as premature preterm rupture of membranes, pre-eclampsia, gestational diabetes, and recurrent spontaneous abortion. It is likely that SAA acts as a non-specific DAMP molecule in response to inflammation and trauma experienced under these conditions. Notably, SAA can also be synthesized locally in virtually all gestational tissues. Within these gestational tissues, under the induction by bacterial products, pro-inflammatory cytokines and stress hormone glucocorticoids, SAA may exert tissue-specific effects as a toll-like receptor 4 (TLR4)-sensed DAMP molecule. SAA may promote parturition through stimulation of inflammatory reactions via induction of pro-inflammatory cytokines, chemokines, adhesion molecules and prostaglandins in the uterus, fetal membranes and placenta. In the fetal membranes, SAA may also facilitate membrane rupture through induction of matrix metalloproteases (MMPs)- and autophagy-mediated collagen breakdown and attenuation of lysyl oxidase-mediated collagen cross-linking. SAA synthesized in extravillous trophoblasts may promote their invasiveness into the endometrium in placentation. Here, we summarized the current understanding of SAA in pregnancy with an aim to stimulate in-depth investigation of SAA in pregnancy, which may help better understand how inflammation is initiated in gestational tissues in both normal and abnormal pregnancies.

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Section: Pprom and Chorioamnionitissupporting

confidence: 54%

Section: Pprom and Chorioamnionitismentioning

confidence: 99%

Serum amyloid A, a host-derived DAMP in pregnancy?

et al. 2022

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“…In four studies, there were no significant differences between the study and control groups in demographic and clinical characteristics such as maternal age (years), BMI, gravidity, parity, and gestational age at admission. One study shows a statistically significant difference in maternal age [ 22 ]. All included studies showed a statistically significant difference in serum SAA levels between the two groups.…”

Section: Resultsmentioning

confidence: 99%

“… The effect size and heterogeneity based on omitting different included studies [ 22 , 23 , 24 , 25 , 26 ]. …”

Section: Figurementioning

confidence: 99%

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Maternal Serum Amyloid A as a Marker of Preterm Birth/PROM: A Systematic Review and Meta-Analysis

Chiriac,

Vilceanu,

Maghiar

et al. 2023

Medicina

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Background and Objectives: Preterm birth, one of the leading causes of neonatal mortality, occurs in between 5 and 18% of births. Premature birth can be induced by a variety of triggers, including infection or inflammation. Serum amyloid A, a family of apolipoproteins, increases significantly and rapidly at the onset of inflammation. This study aims to systematically review the results of studies in the literature that have examined the correlation between SAA and PTB/PROM. Materials and Methods: To examine the correlation between serum amyloid A levels in women who gave birth prematurely, a systematic analysis was performed according to PRISMA guidelines. Studies were retrieved by searching the electronic databases PubMed and Google Scholar. The primary outcome measure was the standardized mean difference in serum amyloid A level comparing the preterm birth or premature rupture of membranes groups and the term birth group. Results: Based on the inclusion criteria, a total of 5 manuscripts adequately addressed the desired outcome and were thus included in the analysis. All included studies showed a statistically significant difference in serum SAA levels between the preterm birth or preterm rupture of membranes groups and the term birth group. The pooled effect, according to the random effects model, is SMD = 2.70. However, the effect is not significant (p = 0.097). In addition, the analysis reveals an increased heterogeneity with an I2 = 96%. Further, the analysis of the influence on heterogeneity found a study that has a significant influence on heterogeneity. However, even after outline exclusion, heterogeneity remained high I2 = 90.7%. Conclusions: There is an association between increased levels of SAA and preterm birth/PROM, but studies have shown great heterogeneity.

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