Palfi M, Hildén J O, Gottvall T, Selbing A
Department of Transfusion Medicine and Clinical Immunology, University Hospital, Linköping, Sweden.
Am J Reprod Immunol. 1998 May;39(5):323-8. doi: 10.1111/j.1600-0897.1998.tb00525.x.
The following questions were addressed: Is the placental transport of immunoglobulin (Ig)G, IgG1, and IgG3 diminished in pregnancies at risk of hemolytic disease of the newborn? Is the placental transport of IgG, IgG1, and IgG3 correlated with the hemoglobin concentration in the fetus and AutoAnalyzer (AA) quantitations of maternal anti-D?
IgG concentrations were determined retrospectively in 41 paired fetal/maternal (f/m) samples in 31 Rh (D) alloimmunized pregnancies. IgG1 and IgG3 concentrations were determined in those 23 cases in which the results of fetal hemoglobin concentration and quantitations of maternal anti-D were available. The results were compared with values found in normal pregnancy and correlated with maternal anti-D AA quantitations and fetal hemoglobin concentrations.
Fetal IgG, IgG1, and IgG3 concentrations, and the corresponding fetomaternal ratios in Rh (D) alloimmunized pregnancies, increased with gestational age according to the following formulas (obtained by simple regression): Fetal IgG = -8.846 + 0.491.gestational age (GA), (R2 = 0.544); fetal IgG = 10.021 + 0.46.GA (R2 = 0.463); fetal IgG3 = -0.865 + 0.039.GA, (R2 = 0.327); f/m IgG = -1.006 + 0.054.GA, (R2 = 0.557); f/m IgG1 = -1.876 + 0.085.GA, (R2 = 0.654); f/m IgG3 = -0.199 + 0.026.GA, (R2 = 0.146).
The placental transport of IgG, IgG1, and IgG3 in women with Rh (D) immunizations is not diminished compared with normal pregnancy. However, AA quantitations of anti-D are inversely correlated with f/m IgG ratio, f/m IgG1 ratio, and fetal IgG and IgG1 concentrations (P = 0.002, P = 0.004, P = 0.02, and P = 0.02 respectively). The placental transport of IgG3 is significantly higher in pregnancies at risk of hemolytic disease of the newborn compared with IgG3 concentrations in normal pregnancy.
探讨了以下问题：在有新生儿溶血病风险的妊娠中，免疫球蛋白（Ig）G、IgG1和IgG3的胎盘转运是否减少？IgG、IgG1和IgG3的胎盘转运与胎儿血红蛋白浓度及母体抗-D的自动分析仪（AA）定量是否相关？
回顾性测定了31例Rh（D）同种免疫妊娠中41对胎儿/母体（f/m）样本中的IgG浓度。在23例可获得胎儿血红蛋白浓度和母体抗-D定量结果的病例中测定了IgG1和IgG3浓度。将结果与正常妊娠中的值进行比较，并与母体抗-D AA定量及胎儿血红蛋白浓度相关联。
Rh（D）同种免疫妊娠中胎儿IgG、IgG1和IgG3浓度及其相应的母胎比值随孕周增加，符合以下公式（通过简单回归获得）：胎儿IgG = -8.846 + 0.491×孕周（GA），（R2 = 0.544）；胎儿IgG1 = 10.021 + 0.46×GA（R2 = 0.463）；胎儿IgG3 = -0.865 + 0.039×GA，（R2 = 0.327）；f/m IgG = -1.006 + 0.054×GA，（R2 = 0.557）；f/m IgG1 = -1.876 + 0.085×GA，（R2 = 0.654）；f/m IgG3 = -0.199 + 0.026×GA，（R2 = 0.146）。
与正常妊娠相比，Rh（D）免疫女性中IgG、IgG1和IgG3的胎盘转运未减少。然而，抗-D的AA定量与f/m IgG比值、f/m IgG1比值以及胎儿IgG和IgG1浓度呈负相关（分别为P = 0.002、P = 0.004、P = 0.02和P = 0.02）。与正常妊娠中的IgG3浓度相比，有新生儿溶血病风险的妊娠中IgG3的胎盘转运显著更高。
