Increased Levels of hsa-miR-199a-3p and hsa-miR-382-5p in Maternal and Neonatal Blood Plasma in the Case of Placenta Accreta Spectrum.

Summary

In 160 maternal-neonatal plasma samples, PAS was associated with elevated neonatal hsa-miR-199a-3p and hsa-miR-382-5p levels. When antenatal corticosteroids were administered within 14 days before delivery, these miRNA levels trended toward normalization, suggesting a molecular link between PAS, steroid timing, and neonatal respiratory morbidity.

Key Findings

• Neonates born to mothers with PAS had significantly higher plasma hsa-miR-199a-3p and hsa-miR-382-5p levels versus controls.
• Antenatal corticosteroids given within 14 days before delivery were associated with a trend toward normalization of these miRNAs.
• A direct correlation was observed between neonatal plasma hsa-miR-382-5p and hsa-miR-199a-3p levels (r = 0.49).

Clinical Implications

For pregnancies complicated by PAS, timing antenatal corticosteroids within 14 days of delivery may confer respiratory benefit detectable at the molecular level; miR-199a-3p/miR-382-5p could be explored as response/risk markers.

Limitations

• Observational design limits causal inference regarding steroid effects
• Abstract truncation leaves some details (e.g., effect sizes) unclear
• Generalizability may be limited to late-preterm PAS populations

Future Directions

Prospective studies validating miR-199a-3p/miR-382-5p as biomarkers for neonatal respiratory outcomes in PAS and testing optimized steroid timing protocols.