Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Am J Obstet Gynecol. 2010 Mar;202(3):268.e1-7. doi: 10.1016/j.ajog.2009.10.875. Epub 2010 Jan 1.
The investigators tested the hypothesis that maternal-fetal immune interactions could be important in initiating spontaneous labor onset by examining if labor was delayed when fetuses share maternal HLA antigen types.
HLA antigen types A, B, and DR in 200 Danish mother-infant pairs delivering in 42-44 weeks (postterm) were compared with 195 mother-infant pairs delivering in 37-40 weeks (term).
Sharing of HLA A and B antigens was more common than expected in postterm deliveries. Odds ratios were 1.54 (95% confidence interval [CI], 1.01-2.35) and 1.75 (95% CI, 0.87-3.52), respectively (risk per shared antigen: 1.40 [95% CI, 1.04-1.90] per unit increase). Adding stringent birth-length criteria for postmaturity (92 cases; 168 controls) strengthened risks associated with antigen sharing to 1.57 (95% CI, 0.90-2.74) and 2.60 (95% CI, 1.15-5.88), respectively (risk per shared antigen: 1.60 (95% CI, 1.10-2.32).
Postterm-delivered infants had more HLA A and B antigens in common with their mothers, suggesting that recognition of HLA antigen differences by adaptive immunity may have a role in triggering labor onset.
通过检查胎儿是否具有与母体相同的 HLA 抗原类型来延迟分娩，研究人员检验了母体-胎儿免疫相互作用在启动自发性分娩中的重要性。
比较了 200 对在 42-44 周（过期）分娩的丹麦母婴对与 195 对在 37-40 周（足月）分娩的母婴的 HLA 抗原 A、B 和 DR 类型。
过期分娩时 HLA A 和 B 抗原的共享比预期更为常见。比值比分别为 1.54（95%置信区间[CI]，1.01-2.35）和 1.75（95%CI，0.87-3.52）（每共享一个抗原的风险：每个单位增加 1.40[95%CI，1.04-1.90]）。为过期后添加严格的出生长度标准（92 例；168 例对照），使与抗原共享相关的风险增加到 1.57（95%CI，0.90-2.74）和 2.60（95%CI，1.15-5.88）（每共享一个抗原的风险：1.60[95%CI，1.10-2.32]）。
过期分娩的婴儿与母亲具有更多的 HLA A 和 B 抗原，这表明适应性免疫对 HLA 抗原差异的识别可能在触发分娩开始中起作用。
