Serum mannose-binding lectin (MBL) concentrations are reduced in non-pregnant women with previous adverse pregnancy outcomes.

Abstract

Mannose-binding lectin (MBL) is an important component of the innate immunity, and it is responsible not only for opsonization of micro-organisms, but also for efferocytosis. The aim of this study was to investigate whether MBL concentrations and lectin complement pathway activity are altered in non-pregnant women with previous adverse pregnancy outcomes. Patients were divided into four groups on the basis of their history of pregnancy complications, including control patients who had uncomplicated pregnancies and term deliveries (control, n=33), and three groups of patients with a history of pregnancy complications, including preterm labour (n=29), recurrent miscarriage (n=19) or unexplained intrauterine foetal death (IUFD; n=17). All women enrolled in the study had an interval of three to six months following their previous pregnancy, and they agreed to have a blood sample taken. We found significantly higher MBL concentrations and functional activity of the lectin complement pathway in healthy controls who had previous uneventful term pregnancies (1341ng/mL; activity 100% (IQR: 62%-100%)), compared to women with the history of IUFD (684ng/mL, P=.008; activity 8.5% (IQR: 0%-97.8%), P=.011), recurrent miscarriage (524ng/mL, P=.022; activity 44% (IQR: 4%-83%), P=.011) or preterm labour (799ng/mL, P=.022; activity 62.5% (IQR: 0%-83%), P=.003). Our results suggest that inadequate function of the complement lectin pathway is associated with a higher risk of preterm labour, recurrent miscarriage and unexplained intrauterine foetal death.