IMMUNOGENETIC AND SEROLOGICAL INVESTIGATIONS IN NONPREGNANT AND IN PREGNANT-WOMEN WITH A HISTORY OF RECURRENT SPONTANEOUS-ABORTIONS

In the context of a controlled multicenter study on intravenous immuno globulin (IVIG) treatment of patients with a history of unexplained re current spontaneous abortions (RSA), a number of controversial immunol ogical parameters were evaluated prior to and during pregnancy with re spect to their diagnostic and/or prognostic significance. A total of 3 90 serum samples from 52 patients were investigated. Sharing of 2 or m ore HLA (A,B,DR,DQ) antigens was significantly more frequent in RSA co uples than in controls. The rate of cytotoxic or Fc-receptor (FcR)-blo cking antibodies was not significantly lower in RSA patients than in i ndividuals with normal pregnancies. Both tumor necrosis factor-alpha ( TNF-alpha)levels and IgG anticardiolipin antibodies (IgG-ACA) were sig nificantly increased in the patient group. While the occurrence of HLA sharing, cytotoxic/FcR-blocking antibodies and IgG-ACA did not correl ate with the outcome of pregnancy, TNF-alpha levels were found to be s ignificantly higher in patients with subsequent miscarriage than in th ose with successful pregnancy. IgG-ACA, if present, significantly decr eased during the course of successful pregnancy but remained high in p atients with subsequent abortion. It is concluded that the diagnostic and/or prognostic value of HLA sharing and cytotoxic/FcR-blocking anti bodies has been overestimated while TNF-alpha and ACA levels are poten tial diagnostic markers and/or exhibit prognostic significance in subg roups of RSA patients.