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Antiphospholipid antibodies in pre-eclamptic women: relation to growth retardation and neonatal outcome
K E Sletnes1, F Wisløff, N Moe
1Hematological Research Laboratory, Ullevål University Hospital, Oslo, Norway.
Insights
Antiphospholipid antibodies, specifically anticephalin antibodies, were found in 19% of pre-eclamptic women, increasing the risk of fetal growth restriction and neonatal death.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Neonatal Medicine
Background:
- The role of antiphospholipid antibodies in pre-eclampsia requires further investigation.
- Antiphospholipid antibodies are implicated in various pregnancy complications.
Purpose of the Study:
- To determine the prevalence of antiphospholipid antibodies in pre-eclamptic women.
- To assess the impact of these antibodies on fetal growth and neonatal outcomes.
Main Methods:
- A case-control study comparing 37 pre-eclamptic women with 40 normotensive controls.
- Detection of anticephalin antibodies (a type of antiphospholipid antibody).
- Analysis of neonatal birthweight percentiles, growth retardation, and mortality rates.
Main Results:
- Anticephalin antibodies were detected in 19% of pre-eclamptic women versus 0% in controls (p=0.004).
- Neonates of antibody-positive mothers had significantly lower birthweight percentiles (p=0.018) and higher rates of growth retardation (p=0.004).
- A higher incidence of neonatal death was observed in infants of antibody-positive mothers (p=0.003).
Conclusions:
- Positive anticephalin antibody levels in pre-eclamptic women are associated with increased risk of fetal growth restriction.
- These antibodies also correlate with a higher risk of neonatal mortality in pre-eclamptic pregnancies.
Abstract:
The significance of antiphospholipid antibodies in pre-eclamptic women has not been thoroughly elucidated. The purpose of this study was to determine the proportion of pre-eclamptic women who were antiphospholipid antibody positive, and to elucidate the significance of these antibodies regarding growth retardation and neonatal outcome. Positive levels of anticephalin antibodies, which are antiphospholipid antibodies, were detected in 7 (19%) out of 37 pre-eclamptic women, as compared with none of 40 in a control group of normotensive women at similar stage of pregnancy (p = 0.004). The birthweight percentiles of the neonates of anticephalin antibody positive women were significantly lower than those of the neonates of anticephalin antibody negative women (p = 0.018). Four of 7 infants of anticephalin antibody positive women were growth retarded (less than 2.5th percentile). This was a significantly larger proportion than that for anticephalin antibody negative women (3/30) (p = 0.004). The 95% confidence interval for the difference between the two proportions was 0.10 to 0.85. Two of the 7 neonates of anticephalin antibody positive women died during the neonatal period, compared with none of the 30 neonates of anticephalin antibody negative women (p = 0.003). Thus, our study suggests that positive levels of anticephalin antibodies in pre-eclamptic women increase the risk for growth retardation and neonatal death.