Are Anti-β2 Glycoprotein 1 Antibodies Associated with Placenta-Mediated Pregnancy Complications? A Nested Case–Control Study

Leslie Skeith; Karim E. Abou-Nassar; Mark Walker; Tim Ramsay; Ronald Booth; Shi Wu Wen; Graeme N. Smith; Marc A. Rodger

doi:10.1055/s-0038-1641168

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(11): 1093-1099
DOI: 10.1055/s-0038-1641168

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Are Anti-β2 Glycoprotein 1 Antibodies Associated with Placenta-Mediated Pregnancy Complications? A Nested Case–Control Study

Leslie Skeith

¹Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Alberta, Canada

²Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

,

Karim E. Abou-Nassar

³Service d'Hématologie et Axe de Recherche en Cancérologie, Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Gatineau, Quebec, Canada

,

Mark Walker

²Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

⁴Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada

,

Tim Ramsay

²Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

,

Ronald Booth

²Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

,

Shi Wu Wen

²Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

⁴Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada

,

Graeme N. Smith

⁵Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada

,

Marc A. Rodger

²Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

⁴Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada

⁶Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada

› Author Affiliations

Abstract

Background While anti-β2 glycoprotein 1 (anti-β2GP1) antibody positivity is included in the diagnostic criteria for antiphospholipid syndrome (APS), the association between anti-β2GP1 and the obstetrical complications of APS has been inconsistently reported and remains unclear.

Objective We completed a case–control study nested within the Canadian Ottawa and Kingston (OaK) Birth Cohort to evaluate the association between anti-β2GP1 antibody positivity and placenta-mediated pregnancy complications.

Study Design Five hundred cases were randomly selected among pregnant women who experienced any of the following independently adjudicated placenta-mediated pregnancy complications: preeclampsia, placental abruption, late pregnancy loss (≥ 12 weeks' gestation), and birth of a small-for-gestational age (SGA) infant < 10th percentile. Five hundred pregnant women without any placenta-mediated pregnancy complications were selected as controls. Stored blood samples were analyzed for the presence of anti-β2GP1 antibodies by enzyme-linked immunosorbent assay.

Results Anti-β2GP1 immunoglobulin G (IgG) and/or immunoglobulin M (IgM) antibodies in titers ≥ 20 G/M units (> 99th percentile) were present in 24 of 497 (4.8%) of controls and 33 of 503 (6.6%) of cases. There was no significant difference between cases and controls for the composite outcome of any placenta-mediated pregnancy complications (odds ratio, 1.38, 95% confidence interval [CI], 0.8–2.37, p = 0.25).

Conclusion Our results call into question the association between anti-β2GP1 antibodies and placenta-mediated pregnancy complications, with further research needed.

Keywords

antiphospholipid antibodies - antiphospholipid syndrome - pregnancy complications - placenta diseases - pregnancy outcome

Full Text

References

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