To the Editor: In their Research Letter, Dr Habayeb and colleagues1 showed that plasma levels of the endocannabinoid anandamide (N-arachidonoyl-ethanolamine) were approximately 3-fold higher in women in a miscarriage group compared with those in a live birth group and thus were associated with the outcome in patients presenting with threatened miscarriage. This observation extends previous findings that in peripheral blood mononuclear cells, low levels of fatty acid amide hydrolase, the enzyme that metabolizes anandamide, were associated with subsequent miscarriage in women with uncomplicated early pregnancies.2 On this basis, the authors suggest that measurement of anandamide levels may have the potential to improve the prediction and counseling of women at risk of miscarriage.
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