Anti-phosphatidylserine, anti-cardiolipin, anti-β2 glycoprotein I and anti-prothrombin antibodies in recurrent miscarriage at 8-12 gestational weeks.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 08/21/2012
Clinical Article
Sater M.S et al. – This study investigates the association of antibodies to β2-glycoprotein I (anti-β2GPI), cardiolipin (ACA), phosphatidylserine (anti-PS) and prothrombin (anti-PT) with recurrent spontaneous miscarriage (RSM).It was seen that elevated ACA IgM and IgG, and anti–PS IgG antibodies are positively associated with RSM.
Methods- Case–control study involving 277 RSM cases and 288 controls: autoantibody levels were measured by ELISA.
- Differences between cases and controls were analyzed by nonparametric Mann–Whitney test, and logistic regression was used in analyzing the association of autoantibodies with RSM.
- Anti–PS IgG, ACA IgM and IgG, and anti–PT IgM were significantly associated with RSM risk, and differential antibody association was noted according to BMI and primary and secondary RSM.
- Higher prevalence of elevated anti–PS IgG was seen in cases, with the strongest risk above the 99th percentile.
- For ACA IgM, 28 cases (10.1%) and 5 controls (1.7%) were positive, with increasing OR for increasing cut–off points, which was significant at antibody titers >99th percentile.
- For ACA IgG, 101 cases (36.5%) and 13 controls (4.5%) were positive, with graded increase in OR for increasing cut–off points, which was significant at titers >90th percentile (maximal at titers >99th percentile).
- For anti–PT, 23 cases (12.0%) and 9 controls (6.1%) were positive, with increased OR at titers >90th percentile.
- Regression analyses confirmed the independent association of anti–PS IgG, ACA IgM and IgG with RSM, and significant RSM risk was associated with high anti–PS IgG (P < 0.001) and ACA IgM (P < 0.001) titers, and a dose–dependent increase in RSM risk was seen with progressively increased ACA IgG titers.
- No significant association existed between anti–PT IgM and RSM.
