Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Am J Perinatol. 2018 Sep;35(11):1093-1099. doi: 10.1055/s-0038-1641168. Epub 2018 Apr 10.
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.
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.
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.
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, = 0.25).
Our results call into question the association between anti-β2GP1 antibodies and placenta-mediated pregnancy complications, with further research needed.
抗β2 糖蛋白 1（anti-β2GP1）抗体阳性已被纳入抗磷脂综合征（APS）的诊断标准，但抗β2GP1 与 APS 的产科并发症之间的关联尚未得到一致报道，仍不清楚。
我们在加拿大渥太华和金斯顿（OaK）出生队列中进行了一项病例对照研究，以评估抗β2GP1 抗体阳性与胎盘介导的妊娠并发症之间的关系。
在经历以下任何一种独立判定的胎盘介导妊娠并发症的孕妇中随机选择 500 例病例：子痫前期、胎盘早剥、晚期妊娠丢失（≥12 周妊娠）和出生小于胎龄儿（SGA）<第 10 百分位数。选择 500 名无胎盘介导妊娠并发症的孕妇作为对照。通过酶联免疫吸附试验分析储存的血液样本中是否存在抗β2GP1 抗体。
在 497 名对照者中有 24 名（4.8%）和 503 名病例中有 33 名（6.6%）的抗β2GP1 免疫球蛋白 G（IgG）和/或免疫球蛋白 M（IgM）抗体滴度≥20 G/M 单位（>99 百分位）。病例与对照组之间任何胎盘介导的妊娠并发症的复合结局无显著差异（比值比，1.38，95%置信区间[CI]，0.8-2.37， = 0.25）。
我们的结果对抗β2GP1 抗体与胎盘介导的妊娠并发症之间的关联提出了质疑，需要进一步研究。
