Antibodies In Pregnancy Research Articles

Consequences for fetus and neonate of maternal red cell allo-immunisation

AIMSTo study the distribution of clinically important red cell antibodies in pregnancy, and the associated fetal and neonatal morbidity and mortality.METHODSThe case notes of women with clinically important red cell...

Anti-M Isoimmunization: Management and Outcome at The Ohio State University From 1969 to 1995

Objective: To review the management strategies and outcome in gravidas with anti-M isoimmunization over the past 26 years at The Ohio State University.Methods: Data collected from 115 pregnancies found to have anti-M antibody at The Ohio State University from September 1969 through February 1996 were reviewed retrospectively. We analyzed indirect antiglobulin tests, amniotic fluid with spectrophotometric examination, direct antiglobulin tests, M antigen status, antepartum course, and perinatal outcome.Results: Anti-M antibody was found in 90 women who had 115 pregnancies over 26 years. Among those with positive indirect antiglobulin tests, 104 pregnancies had titers at or below 1:4. Only one patient with an initial low titer experienced more than a three-fold increase to 1:64. Two women underwent a total of eight amniocenteses when titers were at or above 1:128. Forty-two (60%) of the 70 infants tested were positive for M antigen. Nine infants required phototherapy. Eight of these infants were delivered preterm. There was an increase in the number of women seen with anti-M antibody in pregnancy at our institution, with nearly 10% of all gravidas with a positive antibody screen having anti-M alloantibodies. There were no cases of hemolytic disease of the newborn, mild or severe.Conclusion: The prevalence of anti-M isoimmunization may be increasing. The incidence of severe hemolytic disease of the newborn due to anti-M is extremely low. We found no cases in our review of 115 pregnancies, although there have been several cases of severe hemolytic disease of the newborn reported. If anti-M is detected in pregnancy, the titer is low (no more than 1:4), and there is no history of prior pregnancy complications suggesting a hemolytic disease process, we recommend no further testing other than an indirect antiglobulin test at 28 weeks to look for the emergence of other alloantibodies. However, if the initial titer is elevated or there is a concerning obstetric history, serial titers should be performed and amniocenteses reserved for rising titers.

Anticardiolipin antibodies in pregnancy induced hypertension

It was suggested that anticardiolipin antibodies (ACA) were found positive in some obstetrical problems such as recurrent foetal losses, intrauterine growth retardation, etc. The aim of this study was to determine ACA levels in pregnancy induced hypertension (PIH) cases. ACA IgG and IgM levels were measured by the ELISA method in 65 PIH cases and 23 control pregnancies. We could not find any difference between the PIH and the control groups. There was not any statistically significant difference between the subtypes of PIH. According to these results, we say that ACA IgG and IgM levels have no diagnostic and prognostic value in PIH.

Red-cell antibodies in pregnancy: evidence overturned

Red-cell antibodies in pregnancy: evidence overturned

Prevalence and clinical significance of anticardiolipin antibodies in pregnancies complicated by parvovirus B19 infection.

Anticardiolipin antibodies were measured in 60 pregnant women with acute parvovirus B19 infection. Test results for eight (13.3 per cent) women were positive for anticardiolipin antibody. Six of these eight women became negative later, yielding a prevalence of anticardiolipin antibodies of 3.3 per cent (2/60) 6 months after acute parvovirus B19 infection. Anticardiolipin antibody positivity was not associated with an increased risk of abortion, fetal death, or maternal complications. This study suggests that there is an elevated frequency of anticardiolipin antibodies in pregnant women with acute parvovirus B19, probably representing an epiphenomenon. However, this is not associated with an adverse maternal or perinatal outcome.

The prevalence of red cell antibodies in pregnancy correlated to the outcome of the newborn: a 12 year study in central Sweden.

All maternal red cell antibodies found during pregnancy in a 12 year period have been compiled. The efficacy of the current antenatal screening and management programme has been ascertained by reviewing the outcome of all newborns to these immunized mothers. Patient selection was carried out by computerised searching for all known records of registered antibodies during the study period. Each mother's obstetric record and her baby's hospital file was studied and relevant clinical treatment and laboratory data on both mother and child was recorded and analysed. Eight hundred and twenty-one alloantibodies were detected in 629 immunized pregnant women with 753 fetuses. An overall antibody incidence of 0.57% was observed which included 373 clinically significant antibodies found in 261 mothers (0.24%). Multiple antibodies were present in 8.2% of all samples. Anti-D, by itself or in combination with other Rh-antibodies, caused more severe forms of hemolytic disease of the newborn (HDN) with 46% of all Rh-positive babies having phototherapy and 29% having exchange transfusion. Three of 18 Fya-positive infants required phototherapy and one required exchange transfusion and in the 16 Kell-positive babies, three required phototherapy and one required exchange transfusions. Few antibodies to blood group antigens other than those in the Rhesus system were found to cause severe HDN. Antibodies that are generally considered non-significant did not cause HDN in this study. All antibodies that induced HDN were detected in time so that adequate measures could be taken to reduce the effects in the newborn. The antenatal screening and management programme currently in use is considered to be reliable.

Red cell antibodies in pregnancy: there is no 'critical titre'.

The purpose of this study was to determine the predictive value and reliability of using a 'critical titre' when assessing the ability of red cell alloantibodies to cause haemolytic disease of the newborn. Titration studies and clinical follow-up of 418 antenatal cases where the mothers had red cell antibodies were studied retrospectively. The antibody specificities were anti-D (n = 359), anti-c (n = 34), anti-E (n = 19) and anti-K (n = 6). Depending on the titre being lower or higher than 16 in the indirect antiglobulin test, the severity of disease was established on the given therapy. Anti-D antibodies with a titre 16 were present in 20% of all cases associated with transfusion need of the child; for anti-c, -E and -K the figure was 4%. Titres > or = 16 resulted in both groups in 50% of the cases in phototherapy only, or no therapy at all. Titres are therefore not reliable indicators for predicting the severity of haemolytic disease of the newborn. Neither should they be used as a guide to whether or not antenatal intervention is indicated. Alternative quantitative or functional assays that measure cytotoxic lysis or phagocytosis or a combination of both should be performed instead.

Antiphospholipid Antibodies in Pregnancy

Antiphospholipid Antibodies in Pregnancy

Screening for HIV-1 antibodies in pregnancy: Results from the Swedish national program

Screening for HIV-1 antibodies in pregnancy: Results from the Swedish national program

Antiphospholipid antibodies in pregnancy: prevalence and clinical associations

Antiphospholipid antibodies in pregnancy: prevalence and clinical associations

Antiphospholipid Antibodies in Pregnancy

Objective To determine prevalence, clinical association and predictive power of antiphospholipid antibodies in pregnancy. Design To test for the presence of anticardiolipin antibodies and lupus anticoagulant in order to confirm prevalence data which imply that each antibody has the same clinical significance. A detailed obstetric history and the outcome measures were obtained from each patient in the study. Setting National Women's Hospital, Auckland, New Zealand. Subjects Nine hundred and thirty-three consecutively booked pregnant women. Main outcome measures Prevalence of auto-antibodies; perinatal morbidity and mortality; incidence of preeclampsia, growth retardation and fetal distress. Results Nine women (1.0%) had anticardiolipin antibodies, 11 (1.2%) had lupus anticoagulant and two had both antibodies. The fetal mortality rate for women with antibodies was 167/1000. Pre-eclampsia occurred significantly more often in women with auto-antibodies. Conclusion The presence of antiphospholipid antibodies is frequently associated with adverse pregnancy outcome (9/18 pregnancies). High titre anticardiolipin antibodies carry a poor prognosis.

Prevalence of chlamydial antibody in pregnancy

In this matched-pair study 139 pregnant women were matched on the basis of age to an equal number of non-pregnant women with no signs of genital infection. The mean age was 28.7 years (range 20-41). The cut-offs used for detection of chlamydial antibody were 1:64 and 1:128 for IgG and 1:16 for IgA. IgG antibody at 64 was detected in 37.4% of pregnant women, compared to 46% of controls (p = 0.145). There was, however, a statistically significant difference between the groups for IgG at 128 (gravidae = 15.8%; controls = 28%; p = 0.014). IgA were detected in 8.6% and 16.5% of subjects, respectively (p = 0.047). IgG levels did not vary with increasing age among the pregnant women, but rose significantly with age in non-pregnant controls (logistic regression p-values = 0.011 and 0.006, for IgG at 64 and 128, respectively). IgG-positive women in the control group tended to be older than pregnant IgG-positive women (p = 0.06). These differences could not be explained by marital status, parity or use of oral contraceptives. In view of the lack of epidemiological differences, biological explanations might be invoked.

Screening for HIV-1 antibodies in pregnancy: results from the Swedish national programme.

To determine the effectiveness of a national screening programme for HIV infection in pregnant women. Observational study. All pregnant women presenting to antenatal or abortion clinics. Sweden, September 1987 to December 1991. Number and characteristics of infected women. By the end of the study period 510,000 tests had been performed and 54 women with HIV infection identified (1.06/10,000). Of the 33 women identified in Stockholm, 14 women (4.4/10,000) had attended abortion clinics and 19 antenatal clinics (1.8/10,000; p < 0.05). Three women had been intravenous drug users, one was infected through a blood transfusion, and 50 were probably infected sexually. Of the 20 women who attended antenatal clinics early enough to allow an abortion, 12 continued with their pregnancies. Testing of all women, not just those perceived to be at risk, probably contributed to the high uptake of HIV testing. With high uptake such screening provides valuable data on spread of HIV in the heterosexual population and presents opportunity for preventing transmission of HIV to children and partners.

Antiphospholipid antibodies in pregnancy: prevalence and clinical associations.

To determine prevalence, clinical association and predictive power of antiphospholipid antibodies in pregnancy. To test for the presence of anticardiolipin antibodies and lupus anticoagulant in order to confirm prevalence data which imply that each antibody has the same clinical significance. A detailed obstetric history and the outcome measures were obtained from each patient in the study. National Women's Hospital, Auckland, New Zealand. Nine hundred and thirty-three consecutively booked pregnant women. Prevalence of auto-antibodies; perinatal morbidity and mortality; incidence of pre-eclampsia, growth retardation and fetal distress. Nine women (1.0%) had anticardiolipin antibodies, 11 (1.2%) had lupus anticoagulant and two had both antibodies. The fetal mortality rate for women with antibodies was 167/1000. Pre-eclampsia occurred significantly more often in women with auto-antibodies. The presence of antiphospholipid antibodies is frequently associated with adverse pregnancy outcome (9/18 pregnancies). High titre anticardiolipin antibodies carry a poor prognosis.

Prevalence and prognostic significance of anticardiolipin antibodies in pregnancies complicated by human immunodeficiency virus-1 infection

International Journal of Gynecology & ObstetricsVolume 41, Issue 3 p. 337-337 Citations from the literature HIV infection Prevalence and prognostic significance of anticardiolipin antibodies in pregnancies complicated by human immunodeficiency virus-1 infection RR Viscarello, RR ViscarelloSearch for more papers by this authorCJ Williams, CJ WilliamsSearch for more papers by this authorNJ DeGennaro, NJ DeGennaroSearch for more papers by this authorJC Hobbins, JC HobbinsSearch for more papers by this author RR Viscarello, RR ViscarelloSearch for more papers by this authorCJ Williams, CJ WilliamsSearch for more papers by this authorNJ DeGennaro, NJ DeGennaroSearch for more papers by this authorJC Hobbins, JC HobbinsSearch for more papers by this author First published: June 1993 https://doi.org/10.1016/0020-7292(93)90610-9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume41, Issue3June 1993Pages 337-337 RelatedInformation

Antiphospholipid antibodies in pregnancy.

We assessed the relationship between antiphospholipid antibodies and recurrent miscarriage, fetal deaths, and the pregnancy complications--placental abruption, fetal growth retardation and preeclampsia. The subjects were 81 women with a history of 3 or more miscarriages, 62 with a history of fetal death in the index pregnancy, 105 with a poor obstetric history or pregnancy complications and 13 with systemic lupus erythematosus. Antiphospholipid antibodies were found in 41% of women with a history of recurrent miscarriages, 29% with a history of recent intermediate fetal death or stillbirth, 19% with a poor obstetric history and 69% with systemic lupus erythematosus. There is a high incidence of antiphospholipid antibodies in complicated pregnancies. Patients presenting with the above pregnancy disorders should be tested for antiphospholipid antibodies because of the risk conferred on a fetus by their presence and to expand the treatment options.

Prevalence and prognostic significance of anticardiolipin antibodies in pregnancies complicated by human immunodeficiency virus-1 infection

OBJECTIVES: Anticardiolipin antibodies are estimated to occur in 2.2% of all pregnancies and areassociated with adverse outcomes including thrombotic events, fetal wastage, intrauterine growth retardation, and preterm delivery. We studied 32 human immunodeficiency virus-seropositive gravidas (1) to determine the prevalence of anticardiolipin antibodies in pregnant women infected with human immunodeficiency virus-1 and (2) to investigate the association between the presence of anticardiolipin antibodies and pregnancy outcome, disease status, and perinatal transmission of human immunodeficiency virus-1. STUDY DESIGN: Serum samples obtained at the first prenatal visit were analyzed for anticardiolipinimmunoglobulin M and immunoglobulin G by enzyme-linked immunosorbent assay. Relevant antepartum, intrapartum, and postpartum data, including maternal CD4+ lymphocyte subsets, human immunodeficiency virus p24 antigen determinations, Venereal Disease Research Laboratory test, hematocrit, platelet counts, and placental pathologic tissue of the anticardiolipin antibody-positive and anticardiolipin antibody-negative groups were compared. RESULTS: Test results for 17 (53%) of patients were positive for anticardiolipin antibody: 4 had onlyimmunoglobulin M, 1 had only immunoglobulin G, and the remaining 12 had both antibodies. The patients in the anticardiolipin antibody-positive group were delivered of infants with a mean gestational age of 39 weeks and mean birth weight of 2983 gm. In the anticardiolipin antibody-negative group 15 deliveries had a mean gestational age of 36.3 weeks and a mean birth weight of 2330 gm. CONCLUSIONS: We conclude that there is a high prevalence of anticardiolipin antibodies in patients whohave human immunodeficiency virus, which is not associated with adverse maternal or neonatal outcome, maternal human immunodeficiency virus status, or perinatal transmission of human immunodeficiency virus-1. ( Am J Obstet Gynecol 1992;167:1080–5.)

Preferential synthesis of asymmetric antibodies in rats immunized with paternal particulate antigens. Effect on pregnancy

The effect of immunization of female Fischer rats with particulate (spleen cells) (group I) or soluble (supernatant of disintegrated spleen cells) (group II) paternal antigens previous to mating with Buffalo rats was investigated. The percentage of asymmetric IgG molecules in the serum of rats inoculated with particulate antigens was 38% while in those injected with soluble antigens it was 29% and 28% in non-immunized animals. These percentages further increased during pregnancy to 45%, 38% and 37%, respectively. The antipaternal antibody titres, as determined by indirect immunofluorescence (IIF), was much higher in the animals immunized with particulate antigens but the effector activity, judged by complement fixation, was similar in both groups. The same values were observed at the time of mating (after 3 months of immunization) and at day 17 of pregnancy. Fetus and placenta weights and offspring survival were equally greater in group I than in group II or non-immunized rats (group III). The results obtained indicate the preferential synthesis of antipaternal IgG asymmetric antibodies in rats injected with particulate antigens previous to mating and suggests a beneficial effect of these antibodies in pregnancy.

395 The Prevalence and Prognostic Significance of Anticardiolipin Antibodies in Pregnancies Complicated by HIV-1 Infection

395 The Prevalence and Prognostic Significance of Anticardiolipin Antibodies in Pregnancies Complicated by HIV-1 Infection

Glucose Tolerance and Incidence of Pancreatic Islet Cell Antibodies in Pregnancy in Women with Thyroid Autoantibodies

The prevalence of pancreatic islet cell antibodies (ICA) and complement fixing ICA (CF-ICA) and the effect of pregnancy of glucose tolerance was studied in 3 groups of women. One group had thyroid autoantibodies in serum detected in early pregnancy and subsequent development of postpartum thyroiditis (PPT), another group had thyroid autoantibodies without signs of PPT and the third group did not have thyroid autoantibodies or PPT. In the women with thyroid autoantibodies and PPT, ICA were found in one of 12 women (8%, 95% confidence limits 0-38%). In the group with thyroid autoantibodies without PPT, ICA were found in three of 27 women (11%, 2-29%), whereas two of 20 women without thyroid autoantibodies had ICA (10%, 1-32%), N.S. Where present, serum ICA levels were very low and similar in early pregnancy and 6 months postpartum. CF-ICA were only found in two women with thyroid autoantibodies without signs of PPT. In all groups glucose tolerance was impaired in pregnancy when compared to postpartum despite an increased insulin response to glucose ingestion. In pregnancy, however, glucose tolerance was more impaired in the women with thyroid autoantibodies and subsequent PPT, than in the women without thyroid autoantibodies. Postpartum glucose tolerance was similar in all groups. It is concluded, that the presence of thyroid autoantibodies in early pregnancy or development of PPT is not accompanied by an increased prevalence of islet cell antibodies, but women with thyroid autoantibodies and subsequent PPT have a significantly more reduced glucose tolerance in late pregnancy than women without thyroid autoantibodies.