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The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth.
Nielsen, Henriette Svarre; Witvliet, Marian D; Steffensen, Rudi; Haasnoot, Geert W; Goulmy, Els; Christiansen, Ole Bjarne; Claas, Frans.
Afiliação
  • Nielsen HS; The Fertility Clinic, University Hospital Copenhagen, Rigshospitalet, Fertility Clinic 4071, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. henriette.svarre.nielsen@rh.regionh.dk
J Reprod Immunol ; 87(1-2): 67-73, 2010 Dec.
Article em En | MEDLINE | ID: mdl-20605049
Anti-paternal HLA-antibodies are considered a harmless phenomenon during most pregnancies, whereas their role in recurrent miscarriage (RM) patients is disputed. In contrast to primary RM, patients with secondary RM have carried a fetus to term pregnancy prior to a series of miscarriages, which increases the chance that allogeneic fetal cells appear in the maternal circulation. This study investigates the frequency of HLA-antibodies in secondary RM, primary RM patients and parous controls and analyzes whether the presence of HLA-antibodies in early pregnancy is associated with pregnancy outcome. Sera from women with secondary RM (n=56), primary RM (n=13) and parous controls (n=24) were tested for HLA-antibodies using an ELISA assay and complement dependent cytotoxicity. Samples were taken at gestational week 4-5 in 62 (90%) of the patients. HLA-antibodies were significantly more frequent in secondary RM patients with a boy prior to the miscarriages (62%) compared to secondary RM patients with a firstborn girl (29%, p=0.03), primary RM patients (23%, p=0.02) and parous controls (25%, p=0.005). Forty-one percent of HLA-antibody positive pregnant RM patients had a live birth compared to 76% of HLA-antibody negative RM patients, p=0.006 (adjusted OR: 0.22 (0.07-0.68), p=0.008). In conclusion, HLA-antibodies are significantly more frequent in secondary RM patients with a firstborn boy than in other RM patients and controls. The presence of these antibodies in early pregnancy is associated with a reduced chance of a live birth. Further exploring this association may increase our understanding of maternal acceptance of the fetal allograft.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gravidez / Aborto Habitual / Histocompatibilidade Materno-Fetal / Antígenos HLA / Isoanticorpos Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Adult / Female / Humans Idioma: En Revista: J Reprod Immunol Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Dinamarca

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gravidez / Aborto Habitual / Histocompatibilidade Materno-Fetal / Antígenos HLA / Isoanticorpos Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Adult / Female / Humans Idioma: En Revista: J Reprod Immunol Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Dinamarca