Antiphospholipid antibodies and their role in the development of placental dysfunction

Abstract

The objectives: to assess the spectrum and diagnostic value of antiphospholipid antibodies (APLA) by placental dysfunction. Materials and methods. A study of the APLA spectrum in 122 patients with placental dysfunction in the II and III trimesters of pregnancy was carried out. The control group included 64 practically healthy women in the II and III trimesters of pregnancy with a physiological course of gestation and without a complicated reproductive and somatic history. Results. The overall frequency of detection of critical APLA in the group of women with placental dysfunction was 46.7%, while in women with a physiological course of pregnancy there were no cases of a positive serological reaction to the content of APLA. The number of patients with high and medium titers of IgG and IgM (critical APLA) was low – 11.5%. Noncritical APLA (antiphosphatidylethanolamine and antiphosphatidylserine IgM and IgG antibodies) were more often determined in low and medium titers in patients with placental dysfunction without pronounced hemodynamic changes and were detected in 36.9% of cases.Most of the patients with circulating antibodies to cardiolipin and β2-glycoprotein-1 (21 (17.2%) people) had low (up to 20 U/ml) levels of APLA. The median APLA level in patients with placenta-associated complications which were associated with placental dysfunction (28.5 (18.1) was higher than in patients without these complications (18.6 (7.4); P<0.01).Conclusions. The circulation of APLA in the mother’s blood is of a great importance for predicting of the placental dysfunction development and its severity. An increase concentration of circulating APLA in the maternal blood serum correlates with the frequency of severe forms, the timing of the onset of placental dysfunction and the development of placenta-associated pregnancy complications. In placental dysfunction, the APLA spectrum includes lupus anticoagulant, antibodies to cardiolipin, phosphatidylserine and phosphatidylethanolamin. Their identification increases the efficiency of diagnostics of antiphospholipid syndrome.