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Prenatal screening for anticardiolipin antibody.
R W Bendon1, L E Hayden, P E Hurtubise
1Department of Pathology, University of Cincinnati Medical Center, Ohio.
American Journal of Perinatology
|July 1, 1990
Summary
Anticardiolipin antibodies (IgG, IgM) screening in pregnancy showed no practical clinical utility for identifying high-risk pregnancies, despite some correlations with birthweight and maternal factors. Further research is needed.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Perinatal Medicine
Background:
- Anticardiolipin antibodies (immunoglobulin G and M) are linked to recurrent abortion and maternal death.
- Prenatal screening for these antibodies may help identify high-risk pregnancies.
Purpose of the Study:
- To evaluate anticardiolipin antibody titers as a prenatal screening test for high-risk pregnancies.
- To determine the clinical utility of these titers in predicting pregnancy outcomes.
Main Methods:
- Titers of IgG and IgM anticardiolipin antibodies were measured in 686 patients at their first clinic visit (mean gestation, 20 weeks).
- Pregnancy outcomes were extracted from a medical records database.
- Specific tests for coagulopathy and antinuclear antibodies were performed on a subset of patients with elevated titers.
Main Results:
- IgG anticardiolipin showed an inverse correlation with birthweight (p < 0.025).
- IgM anticardiolipin correlated with inverse patient age (p < 0.0002) and chronic hypertension (p < 0.01).
- No correlations were found to be of practical clinical utility; placental examinations showed no infarctions.
Conclusions:
- Anticardiolipin antibody titers do not appear to be a useful prenatal screening tool for identifying high-risk pregnancies.
- The observed correlations lacked practical clinical significance.
- The underlying biological mechanisms require further investigation.