The effects of metabolic indicators and immune biomarkers on pregnancy outcomes in women with recurrent spontaneous abortion: a retrospective study.

Background: The etiology of recurrent spontaneous abortion (RSA) remains elusive despite specific investigations affirming the association between RSA and thyroid autoimmunity (TAI). This study explores the immunological and metabolic profiles of RSA patients exhibiting positive thyroid antibodies and their connection with the rates of first-trimester miscarriage and live births. The aim is to provide further guidance for clinical interventions. Methods: A retrospective analysis included 478 women with RSA. Thyroid profile, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were measured in all participants. The clinical characteristics and pregnancy outcomes of RSA women were compared between thyroid autoimmunity (TAI)-positive and TAI-negative patients. Significant factors associated with adverse pregnancy outcomes and risk prediction models were explored in TAI-positive patients. Correlation analysis was used to identify specific metabolic or immune biomarkers associated with thyroid autoantibodies. Results: The prevalence of TAI was 18.6%. Compared with women without TAI, the thyroid-stimulating hormone (TSH) concentration of TAI-positive RSA was significantly higher (2.80 ± 2.98 vs 1.89 ± 1.17, p=0.006). After 28 weeks, the live birth rate of the TAI-positive group was lower than that of the TAI-negative group, with statistical significance (p<0.05). The immune biomarkers that differed between RSA women with live births and those with first-trimester miscarriages were complement C4 and interleukin-6, respectively, in TAI-negative and TAI-positive women. Then, a risk prediction model for first-trimester miscarriage was constructed for TAI-positive women with an AUC of 0.81. Finally, some factors related to thyroid peroxidase antibody (TPO-Ab) levels were explored, and it was found that TPO-Ab levels were positively correlated with free thyroxine and negatively correlated with 25 hydroxyvitamin D, interleukin-4, and fasting blood glucose in RSA patients. Conclusion: TAI-positive RSA patients have higher first-trimester miscarriage rates and a lower live birth rate, which may be related to metabolic immune shifts in TAI-positive RSA patients.

[Effects of lianhuang decoction in treating fetomaternal ABO blood group incompatibility].

OBJECTIVE: To investigate the clinical curative effect of Lianhuang Decoction (LHD) in treating fetomaternal ABO blood group incompatibility (FM-ABOI). METHODS: Sixty pregnancy women diagnosed as FM-ABOI were randomly assigned to two groups, Group A treated with LHD and Group B treated with Western medicine. The therapeutic efficacy in the two groups was observed. RESULTS: The antibody titer decreased after treatment in both groups to different extent; the effective rate was 90.0% in Group A and 56.7% in Group B. The bilirubin level in cord blood of Group A was lower than that in Group B significantly (P<0.01). No statistically significant difference was found between the two groups new-bom in terms of 5-minute Apgar score, body weight and hemoglobin content in cord blood (P>0.05). CONCLUSION: LHD has good clinical curative effect in treating FM-ABOI, could decrease the serum antibody titer, and prevent the occurrence of postpartum hemolytic disease in newborns.

[Changes of serum epithelial neutrophil-activating peptide-78 in patients with endometriosis].

OBJECTIVE: To investigate the role of serum epithelial neutrophil-activating peptide-78 (ENA-78) in the pathogenesis of endometriosis. METHODS: Serum concentrations of ENA-78 were measured by means of enzyme-linked immunosorbent assay (ELISA) in 42 patients with endometriosis (20 in stages I and II and 22 in stages III and IV) in comparison with 25 women without endometriosis (control group). RESULTS: Serum concentrations of ENA-78 were significantly higher in endometriosis group than in the control group (2.97+/-1.91 ng/ml vs 0.72+/-0.24 ng/ml, P>0.001), and ENA-78 levels in stages III and IV were significantly higher than those in stages I and II (4.48+/-1.25 ng/ml vs 1.30+/-0.74 ng/ml, P>0.001). Significant difference in ENA-78 levels between follicular phase and luteal phase was found in neither of the groups. CONCLUSION: Patients with endometriosis have elevated serum ENA-78 levels, which might be a pathogenic factor of endometriosis.