Sezcan Mumusoglu1, Mehmet Sinan Beksac1, Ali Ekiz2, Pinar Ozdemir3, Gulsen Hascelik4. 1. a Department of Obstetrics and Gynecology , Hacettepe University Faculty of Medicine , Ankara , Turkey . 2. b Department of Obstetrics and Gynecology , Kanuni Sultan Suleyman Education and Research Hospital , Istanbul , Turkey . 3. c Department of Biostatistics , Hacettepe University Faculty of Medicine , Ankara , Turkey , and. 4. d Department of Clinical Microbiology , Hacettepe University Faculty of Medicine , Ankara , Turkey.
Abstract
OBJECTIVE: To assess whether the presence of autoantibodies has any effect on recurrent pregnancy loss (RPL) and obstetric complications in women who do not have autoimmune diseases and hereditary thrombophilia. METHODS: Retrospectively, 515 patients who underwent antibody investigation with anti-nuclear antibody, extractable nuclear antigen, anti-double stranded DNA, anti-parietal cell, anti-smooth muscle, anti-mitochondrial (AMA), anti-thyroid peroxidase, anti-thyroglobulin (anti-TG) and anti-phospholipid (aPL) at Hacettepe University were included. Of those patients, 212 had one or more autoantibodies whereas the remaining 303 were negative for all autoantibodies. RPL was the primary outcome and was defined as ≥2 pregnancy losses (n = 119). RESULTS: The frequency of RPL was significantly higher in the autoantibody positive group than controls (28.3% versus 14.5%, p<0.001). Anti-TG (21.2% versus 7.8%, p < 0.001), aPL (18.3% versus 5.6%, p < 0.001) and AMA (4.8% versus 0.5%, p = 0.001) antibodies were more common in patients with RPL. For the view of obstetric complications, oligohydramniosis (3.8% versus 0.7%, p = 0.03) and stillbirth (17.0% versus 10.6%, p = 0.002) were significantly higher in the autoantibody-positive group. CONCLUSIONS: Even in women without autoimmune disease or hereditary thrombophilia, autoantibodies per se might directly increase the risk of RPL and obstetric complications. The screening anti-TG and aPL autoantibodies in the first step might be considered in patients with RPL.
OBJECTIVE: To assess whether the presence of autoantibodies has any effect on recurrent pregnancy loss (RPL) and obstetric complications in women who do not have autoimmune diseases and hereditary thrombophilia. METHODS: Retrospectively, 515 patients who underwent antibody investigation with anti-nuclear antibody, extractable nuclear antigen, anti-double stranded DNA, anti-parietal cell, anti-smooth muscle, anti-mitochondrial (AMA), anti-thyroid peroxidase, anti-thyroglobulin (anti-TG) and anti-phospholipid (aPL) at Hacettepe University were included. Of those patients, 212 had one or more autoantibodies whereas the remaining 303 were negative for all autoantibodies. RPL was the primary outcome and was defined as ≥2 pregnancy losses (n = 119). RESULTS: The frequency of RPL was significantly higher in the autoantibody positive group than controls (28.3% versus 14.5%, p<0.001). Anti-TG (21.2% versus 7.8%, p < 0.001), aPL (18.3% versus 5.6%, p < 0.001) and AMA (4.8% versus 0.5%, p = 0.001) antibodies were more common in patients with RPL. For the view of obstetric complications, oligohydramniosis (3.8% versus 0.7%, p = 0.03) and stillbirth (17.0% versus 10.6%, p = 0.002) were significantly higher in the autoantibody-positive group. CONCLUSIONS: Even in women without autoimmune disease or hereditary thrombophilia, autoantibodies per se might directly increase the risk of RPL and obstetric complications. The screening anti-TG and aPL autoantibodies in the first step might be considered in patients with RPL.
Entities:
Keywords:
Autoantibodies; autoimmunity; high-risk pregnancies; miscarriages; recurrent pregnancy loss
Authors: Atakan Tanacan; Erdem Fadiloglu; Gonca Ozten; Ali Can Gunes; Gokcen Orgul; Mehmet Sinan Beksac Journal: Ir J Med Sci Date: 2019-05-09 Impact factor: 1.568
Authors: Kemal Beksaç; Gökçen Örgül; Murat Çağan; Ergun Karaağaoğlu; Serap Arslan; Mehmet Sinan Beksaç Journal: J Turk Ger Gynecol Assoc Date: 2017-03-15