Prevalence of Various Antiphospholipid Antibodies in Pregnant Women
L. Fialová, L. Mikulíková, I. Matouš-Malbohan, O. Benešová1,
A. Zwinger1
First Institute of Medical Chemistry and Biochemistry, First Faculty of
Medicine, Charles University, and 1Institute for Mother and Child
Care, Prague, Czech Republic
Received April 1, 1999
Accepted December 1, 1999
Summary
Antiphospholipid antibodies (APAs) are characterized as a
heterogeneous population of autoantibodies directed against different target
antigens, predominantly anionic phospholipids or phospholipid-containing
structures. The presence of APAs has been strongly associated with a variety of
clinical disorders including adverse pregnancy complications such as spontaneous
abortions, pregnancy-induced hypertension, preeclampsia and intrauterine growth
retardation. The purpose of this study was to compare the prevalence of
anticardiolipin antibodies (ACAs), which are routinely examined, with APAs
directed against phosphatidylserine (APS), phosphatidylinositol (API),
phosphatidylethanolamine (APE) and phosphatidylcholine (APC) in the sera of
pregnant women. We examined 410 serum samples of pregnant women hospitalized in
the department for pathological pregnancies. They underwent prenatal biochemical
screening of fetal congenital abnormalities in the first and the second
trimester of gravidity. Anticardiolipin IgG and IgM were measured using
commercial ELISA kits (ImmuLisaTM Anti-Cardiolipin Antibody), whereas
APS, APE, API and APC were determined by our modified ELISA kit. Among 410
pregnant women we found 21 patients (5.1 %) positive for ACA IgG (>20
GPL) and 30 patients (7.3 %) positive for ACA IgM (>10 MPL). It was found
that 7.8 % of pregnant women had at least one high-titer APA IgG and 9.8 %
high-titer APA IgM. One third of ACA IgG or IgM positive sera contained
polyspecific autoantibodies reactive to at least two various phospholipids. In
the group of IgG ACA positive women, 28.6 % patients were positive for APS, 28.6
% were positive or moderately positive for API, 23.8 % for APC and 19 % for APE.
In the group of IgM ACA positive women, 33.3 % were also positive for APS, 26.7
% for APE, 26.7 % for API and 23.3 % for APC were present. IgG and IgM ACA
negative patients exhibited a significantly lower incidence of other APA than
the group of ACA positive pregnant women. It still remains to clarify if the
routine examination of APA reacting with other anionic and zwitterionic antigens
other than cardiolipin would improve the probability of identifying women liable
to adverse pregnancy complications.
Key words
Antiphospholipid antibodies ·
Anticardiolipin antibodies · Pregnancy ·
Phospholipids
Reprint requests
MUDr. Lenka Fialová, First Institute of Medical Chemistry
and Biochemistry, First Faculty of Medicine, Charles University, Kateřinská
32, 128 01 Praha 2, Czech Republic.
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