کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6188458 | 1600718 | 2010 | 7 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth](/preview/png/6188458.png)
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.
Journal: Journal of Reproductive Immunology - Volume 87, Issues 1â2, December 2010, Pages 67-73