Early Detection of Miscarriage in Recurrent Pregnancy Loss Using a Novel Urinary Biomarker

Background: Recurrent pregnancy loss (RPL) is a multifactorial reproductive disorder characterized by the occurrence of two or more consecutive pregnancy losses before 20 weeks of gestation. Objective: To assess metabolic (HbA1c, TSH), immunological antiphospholipid antibodies (aPLA) (IgM and IgG), and urinary (chemerin, adipsin) biomarkers in women with recurrent pregnancy loss and to evaluate their potential as predictors of subsequent miscarriage. Methods: In this case-control study, 92 women participated; 46 had experienced two or more consecutive pregnancy losses before 20 weeks of gestation, and 46 were healthy control women. Venous blood samples were collected to assess levels of TSH, Hb, HbA1c, and aPLA (IgG and IgM). Additionally, urine samples were collected and processed for the examination of chemerin, adipsin, and cAMP concentrations. Results: A total of ninety-two women were involved in the study. The RPL group showed significantly higher TSH, HbA1c, aPLA (IgG, IgM), and urinary chemerin, adipsin, and cAMP compared with controls. Strong correlations with RPL were observed for HbA1c (r= 0.636) and urinary adipsin (r= 0.677), with moderate correlations for TSH (r= 0.514), chemerin (r= 0.598), cAMP (r= 0.474), aPLA IgG (r= 0.460), and aPLA IgM (r= 0.578). Logistic regression identified elevated HbA1c, TSH, adipsin, chemerin, aPLA IgG/IgM, and maternal age as significant predictors of RPL. Conclusions: Metabolic (TSH, HbA1c), immunological (IgG, IgM), and urinary biomarkers (chemerin, adipsin, cAMP) are significantly associated with increased risk of recurrent pregnancy loss. These urinary markers may offer novel approaches for early diagnosis and risk prediction in RPL.