Does the Maternal Serum IgG Level during Pregnancy in Primary Antibody Deficiency Influence the IgG Level in the Newborn?

Vasantha Nagendran,Amolak S Bansal,Noel Emmanuel

doi:10.1155/2015/286380

Abstract

Purpose. To find out if the serum IgG level in the newborn baby was affected by low maternal serum IgG during pregnancy in two newly diagnosed primary antibody deficient patients. Method. Infant cord blood IgG level was compared with maternal IgG level in 2 mothers with newly diagnosed primary antibody deficiency, who declined replacement IgG treatment during pregnancy. Results. Both mothers delivered healthy babies with normal IgG levels at birth. Conclusions. The normal IgG levels and sound health in these 2 babies in spite of low maternal IgG throughout pregnancy raise interesting discussion points about maternofoetal immunoglobulin transport mechanisms in primary antibody deficiency.

Highlights

It is conventional wisdom that the foetus and neonate depend on transplacental transfer of IgG antibodies from the mother for immune protection, until maturation of their own humoral immunity
Common variable immunodeficiency (CVID) and hyper IgM syndrome (HIGM) which was previously included under the umbrella of CVID are heterogeneous primary antibody deficiency states characterised by low IgG and impaired antibody responses
If pregnant mothers with CVID or HIGM had no RIT, placental transfer of IgG may be reduced, causing a deficiency of protective antibodies to defend the foetus from intrauterine infections

Summary

Introduction

It is conventional wisdom that the foetus and neonate depend on transplacental transfer of IgG antibodies from the mother for immune protection, until maturation of their own humoral immunity. Common variable immunodeficiency (CVID) and hyper IgM syndrome (HIGM) which was previously included under the umbrella of CVID are heterogeneous primary antibody deficiency states characterised by low IgG and impaired antibody responses Management of both of these conditions involves replenishing the IgG deficiency and monitoring and treating infections, autoimmune diseases, and other complications. If pregnant mothers with CVID or HIGM had no RIT, placental transfer of IgG may be reduced, causing a deficiency of protective antibodies to defend the foetus from intrauterine infections. This lack of passive immunity may increase the risk of infection in the child’s first few months of life, until its immune system matures. We report our experience of 2 women in this situation who declined replacement immunoglobulin therapy during their pregnancy

Case Reports

Discussion

Findings

Conclusion