The Role of Inflammation and Autoimmunity in First Trimester Spontaneous Abortion [26G]

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Abstract

INTRODUCTION:

Spontaneous abortion is closely related to embryonic aneuploidy. However, etiology of spontaneous euploid abortion is poorly understood. I hypothesized that abnormal inflammation and/or autoimmunity may predispose to euploid losses.

METHODS:

Inflammatory and immune serum markers of sixty subfertile women with first trimester spontaneous abortion between 2010 and 2015 were compared based on ploidy of products of conception. Fifteen women (e-SAB) had euploid and forty-five women (an-SAB) had aneuploid losses. Inflammatory markers included Adiponectin, C-Reactive Protein (CRP), Immunoglobulin-6 and Leptin. Autoimmune markers included Antinuclear antibody (ANA), Immunoglobulins antibodies (IgA, IgG, IgM, IgE), Antiphospholipid Antibodies (IgA, IgG, IgM), Thyroid peroxidase antibody (TPO), Antithyroglobulin antibody (TG) and Thyrotropin receptor antibody (TR). Statistical comparisons were made using a two-sided Fisher's exact test or t test as appropriate.

RESULTS:

Patient characteristics were not statistically different between the euploid and aneuploidy groups. Patients in both groups were of advanced maternal age, those with euploid losses showed a trend toward increased autoimmunity and inflammatory profiles compared to patients with aneuploid losses. An absolute difference of 14% (P=.652) in inflammatory markers and 17% (P=.330) in immune markers were observed between the two groups. Due to small sample size, statistical significance was not reached between the two groups. A post-hoc analysis indicates that a sample size of 107 per group would be needed to establish significance based on this absolute difference in immune markers.

CONCLUSION:

Larger studies of patients with euploid pregnancy loss are needed to better characterize potential underlying inflammatory and immune etiologies. Only then, can efficacy of treatments aimed at the inflammatory pathways and immune system be studied in such patients.

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