Serum Immunoglobulin Changes in Pregnancy Complicated with Pre-Eclampsia and Diabetes in Nigerian Women

Abstract

Objectives: Serum concentrations of IgA, IgG and IgM were determined in subjects with pre-eclampsia and gestational diabetes as compared to both apparently healthy pregnant and non-pregnant subjects resident in Port Harcourt, Nigerian. Materials and methods: A total of 200 femalesubjects comprising four groups of 50 subjects each were recruited into the study: healthy non-pregnant subjects (Group A); healthy pregnant subjects (Group B); subjects with pre-eclampsia (Group C) and subjects with gestational diabetesmellitus (Group D). All pregnant subjects were further subdivided into the appropriate semester according to gestational age of pregnancy. Venousblood samples were obtained and determined for immunoglobulins A, G and M with theturbidimetric immunoassay method usingan automated chemical analyzer. Results: Significant differences were observed in the values of the various types of immunoglobulins studied between healthy HIV sero-negative non-pregnant (group A) subjects and healthy HIV sero-negative pregnant (group B) subjects. Noteworthy is the observation that the values of both IgG and IgM were significantly higher while the values of IgA were significantly lower amongst the non-pregnant subjects in group A, compared to all the other pregnant subject groups: B, C and D (p<0.05). Furthermore, group B subjects were found to have significantly higher values of IgG and lower levels of IgM compared to groups C and D subjects (p<0.05). Values of IgA were significantly higher (P<0.05) in all pregnant groups compared to the non-pregnant subjects but highest in the GDM (group D) women.During the course of gestation, a graded decrease in the mean values of all three immunoglobulin classes was observed in the healthy pregnant group from the 1 st to 3 rd trimester. However, whereas a graded increase in mean IgA and IgM were observed in group C subjects across trimesters, mean IgG showed a similar graded but significant decrease (P<0.05). Also, the mean IgG decreased significantly in the pregnant diabetic (D) group in the 2 nd trimester,but that of IgM significantly increased in the 2 nd trimester. Conclusion: The observed changes in immunoglobulins A, G and M levels may be indicative of poorly transferred secondary immunity in the children born to pregnant diabetic and pre-eclamptic women, as well as pose complications related to indirect immune responses in these conditions.