Strengths and Limitations
To our knowledge, the present study is the first to examine the relationship between TAFI and the risk of RSA based on the ATA profile. However, this study has several limitations worth mentioning. First, as a single-center study, there are some bias in testing TAFI and other indicators only in patients from a single study center. Second, all participants in this study were from Liaoning province, China, and extrapolation of our results to other populations with different demographic characteristics or to other regions should be done with caution. Third, confounding due to unknown or unmeasured factors, such as maternal medication use during pregnancy, cannot be excluded. Last, our study did not measure inflammatory mediators levels to further validate. More large cohort studies are needed in the future to further investigate and validate our results, and to study whether inflammatory mediators play a key role in RSA. In addition, the pathological mechanisms by which low TAFI levels lead to an increased risk of RSA need to be further investigated.
Conclusions:  In summary, our study suggests that pregnant women with plasma TAFI levels below the normal range, especially in ATA-positive populations, are at higher risk for RSA. Therefore, pregnant women with low TAFI levels and ATA-positive should be vigilant for the occurrence of RSA, which has made a certain contribution to the prevention of RSA.