Fukushige Mami, Lu Xi, Satoh Minoru, Oda Masako, Ohba Takashi, Katoh Takahiko
Department of Nursing, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku, Kumamoto, Kumamoto, 862-0976, Japan.
Kumamoto University Regional Centre, The Japan Environment and Children's Study (JECS), 718, Medical Research Building, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan.
BMC Pregnancy Childbirth. 2024 Dec 28;24(1):879. doi: 10.1186/s12884-024-07084-9.
Antinuclear antibodies (ANA) are important biomarkers for the diagnosis of autoimmune diseases; however, the general population also tests positive at a low frequency, especially in women. Although the effects of various autoimmune diseases on pregnancy outcomes have been studied, the association of ANA with pregnancy outcomes in healthy individuals is unclear. Preterm birth (PTB), a major cause of neonatal death or long-term health problems, is a complex condition with a multifactorial etiology, and the underlying mechanism remains unclear. The present Adjunct Study aimed to determine the association between ANA and PTB in pregnant Japanese women based on a data analysis of the Japan Environment and Children's Study.
In a prospective cohort design, we analyzed the demographic and pregnancy outcome data of 1085 pregnant Japanese women who were recruited between January 2011 and March 2014 in the Kumamoto University target area. Demographic data were collected using self-administered questionnaires and physician records. A serum ANA titer of ≥ 1:40 was defined as positive. Statistical analysis was performed by logistic regression analysis with PTB as the objective variable.
The PTB rate was significantly higher in those who were ANA-positive (adjusted odds ratio, 2.06; 95% confidence interval, 1.09-3.87) than in those who were not.
This study suggests that ANA positivity in the first trimester of pregnancy is associated with an increased risk of PTB.
抗核抗体（ANA）是诊断自身免疫性疾病的重要生物标志物；然而，普通人群中也有低频率的检测呈阳性情况，尤其是在女性中。尽管已经研究了各种自身免疫性疾病对妊娠结局的影响，但ANA与健康个体妊娠结局之间的关联尚不清楚。早产（PTB）是新生儿死亡或长期健康问题的主要原因，是一种病因复杂的多因素疾病，其潜在机制仍不清楚。本辅助研究旨在基于日本环境与儿童研究的数据分析，确定日本孕妇中ANA与PTB之间的关联。
在一项前瞻性队列设计中，我们分析了2011年1月至2014年3月在熊本大学目标地区招募的1085名日本孕妇的人口统计学和妊娠结局数据。人口统计学数据通过自我填写问卷和医生记录收集。血清ANA滴度≥1:40被定义为阳性。以PTB为目标变量，通过逻辑回归分析进行统计分析。
ANA阳性者的PTB发生率显著高于ANA阴性者（调整后的优势比为2.06；95%置信区间为1.09 - 3.87）。
本研究表明，妊娠早期ANA阳性与PTB风险增加有关。
