Evaluation of Apelin-13 and Apelin-36 Concentration in Women with Primary Unexplained Recurrent Pregnancy Loss

Abstract Background According to the American College of Obstetricians and Gynecologists, recurrent pregnancy loss is a disease, defined as two or more failed pregnancies. Recurrent pregnancy loss is one of the most frustrating and difficult areas of reproductive medicine because up to 50.0% of cases lack clearly defined etiology. Common conditions that have been associated with recurrent pregnancy losses include uterine abnormalities, parental chromosomal aberrations, various endocrine disturbances and the presence of antiphospholipid antibodies. Aim of the Work to evaluate the potential role of apelin-13 and apelin-36 in patients with primary unexplained recurrent early pregnancy loss. Patients and Methods after ethical committee approval and informed consent from the patients, this case control study was conducted at tertiary care hospital at Ain Shams University hospitals from March 2022 to December 2022 and performed on total of 90 women who attended the outpatient antenatal clinics in their first trimester of pregnancy. Results The current study revealed that there were no significant differences between recurrent pregnancy loss group and control group regarding demographic characteristics; age, body mass index and gestational age (p values = 0.582, 0.278, 0.548) respectively. Our study results revealed that Apelin-13 and Apelin-36 were statistically significantly higher in recurrent pregnancy loss group than in control group (p value<0.001). Our results enhance the prognostic significance of high Apelin sub-fragment concentrations in the pathophysiology of unexplained recurrent pregnancy loss and suggests that apelin-13 and/or apelin-36 may be inhibited or decreased by potential drugs for the treatment of unexplained recurrent pregnancy loss. Conclusion the current study investigated serum apelin-13 and apelin-36 concentrations in women with unexplained recurrent pregnancy loss and demonstrated markedly higher serum concentrations compared to healthy pregnant women. We are of the opinion that our findings are not only significant to reveal the role of the Apelin sub-fragments in the pathophysiology of unexplained pregnancy loss; but also, they will provide information as a reference for the future studies, which will investigate the treatment strategies for the treatment unexplained pregnancy loss, and its associated complications in pregnancy.