McCowan Lesley M E, Chamley Larry W
Department of Obstetrics and Gynaecology, National Women's Hospital, University of Auckland, Auckland, New Zealand.
Aust N Z J Obstet Gynaecol. 2004 Feb;44(1):14-8. doi: 10.1111/j.1479-828X.2004.00148.x.
Small for gestational age (SGA) babies are more common in women with antiphospholipid antibodies but data are limited about the prevalence of antiphospholipid antibodies in women who have delivered SGA babies.
To determine whether elevated levels of anticardiolipin, antiphosphatidyl serine and/or antibeta2 glycoprotein I antibodies are more common in normotensive women who delivered SGA babies compared with women who delivered appropriate for gestational age babies.
Case-control study. Cases were normotensive women who delivered an SGA baby (birthweight <10th%) without chromosomal or congenital abnormality. Controls were healthy women who delivered a baby at term with birthweight >10th percentage.
A total of 137 women with SGA pregnancies and 290 controls had antiphospholipid antibodies measured. The prevalence of anticardiolipin and antibeta2 glycoprotein I antibodies did not differ between SGA cases and controls. Antiphosphatidyl serine IgG antibodies were more common in women with SGA pregnancies than controls seven (5%) versus five (1.7%), relative risk (RR) 1.84 (1.12-3.03). There was no difference in the prevalence of 'any antiphospholipid antibodies' between SGA 10 (7.2%) and controls 16 (5.6%). There was a trend to more abnormal umbilical Doppler studies in SGA pregnancies with positive antiphospholipid antibodies three (50%) versus 19 (24%), RR 2.9 (0.62-13).
Antiphospholipid antibodies were uncommon in this cohort of SGA pregnancies. Further studies are needed in SGA pregnancies with abnormal umbilical Doppler studies to determine if screening for antiphospholipid antibodies is worthwhile in this severe subgroup.
小于胎龄儿(SGA)在患有抗磷脂抗体的女性中更为常见,但关于分娩SGA婴儿的女性中抗磷脂抗体的患病率数据有限。
确定与分娩适于胎龄儿的女性相比,分娩SGA婴儿的血压正常女性中抗心磷脂、抗磷脂酰丝氨酸和/或抗β2糖蛋白I抗体水平升高是否更为常见。
病例对照研究。病例为分娩SGA婴儿(出生体重<第10百分位数)且无染色体或先天性异常的血压正常女性。对照为足月分娩体重>第10百分位数婴儿的健康女性。
共对137例SGA妊娠女性和290例对照进行了抗磷脂抗体检测。SGA病例组和对照组中抗心磷脂和抗β2糖蛋白I抗体的患病率无差异。抗磷脂酰丝氨酸IgG抗体在SGA妊娠女性中比对照组更常见,分别为7例(5%)和5例(1.7%),相对危险度(RR)为1.84(1.12 - 3.03)。SGA组10例(7.2%)和对照组16例(5.6%)“任何抗磷脂抗体”的患病率无差异。抗磷脂抗体阳性的SGA妊娠中脐动脉多普勒检查异常的趋势更明显,分别为3例(50%)和19例(24%),RR为2.9(0.62 - 13)。
在这组SGA妊娠中抗磷脂抗体并不常见。对于脐动脉多普勒检查异常的SGA妊娠,需要进一步研究以确定在这个严重亚组中筛查抗磷脂抗体是否值得。