Abstract
This study investigated the relationship between maternal serum amyloid A (SAA) levels, a biomarker of systemic inflammation, and specific neonatal outcomes in preterm birth (PTB). The study included 66 consecutive pregnant women hospitalized for spontaneous preterm delivery (ranging from 28 to 36 gestational weeks), at the Timisoara Municipal Hospital. The study measured mSAA levels to assess their potential as predictors of fetal outcomes (respiratory distress syndrome [RDS]), as well as their association with APGAR score, neonatal leukocyte count, and C-reactive protein (CRP) levels as indicators of neonatal status and response. SAA levels were measured as part of the study protocol for all participants admitted with spontaneous preterm labor symptoms. The results showed a significant negative correlation between mSAA and APGAR score (r = -0.272, two-tailed P-value = 0.027). This finding suggests that elevated maternal inflammation may adversely impact the neonate's condition at birth. Additionally, a moderate positive correlation was observed between SAA and neonatal leukocyte count (r = 0.538, P < 0.001), reflecting a neonatal inflammatory response. However, SAA was not a significant predictor for RDS (odds ratio [OR] = 1.005, P = 0.31). While these findings are promising, they must be interpreted with caution due to limitations such as the small sample size and the cross-sectional nature of the study design. These results suggest that elevated mSAA levels may be associated with immediate adverse neonatal outcomes, supporting the use of inflammatory biomarkers to identify neonatal risks, but further studies are needed for validation.