PREGNANCY LOSS AND AUTOANTIBODIES AGAINST PHOSPHOLIPID-BINDING PROTEINS

Objective: To evaluate the relationship between antibodies against bet a(2)-glycoprotein I or prothrombin and pregnancy losses in women with antiphospholipid antibodies. Methods: Women with antiphospholipid anti bodies, (lupus anticoagulant and/or anticardiolipin antibodies), with (n = 41) and without (n = 61) a history of pregnancy loss were evaluat ed. Thirty-one out of the forty-one patients with pregnancy loss had e arly miscarriages (at less than 13 weeks) and ten patients had late mi scarriages. Immunoglobulin (Ig)-G and IgM anti-beta(2)-glycoprotein I and anti-prothrombin antibodies were measured by an enzyme-linked immu nosorbent assay method. Results: A significant association between pre gnancy loss and positive IgM anti-beta(2)-glycoprotein I antibodies wa s found (odds ratio 2.6; 95% confidence interval 1.03, 6.6; P = .043). Women with late pregnancy loss had higher levels of both IgG and IgM anti-beta(2)-glycoprotein I antibodies compared with controls (P < .05 ). There was a good correlation between anticardiolipin and anti-beta( 2)-glycoprotein I antibodies levels (IgG: r = 0.75; IgM: r = 0.73). In contrast, there was no correlation between the levels of anticardioli pin or anti-beta(2)-glycoprotein I antibodies and the levels of anti-p rothrommbin antibodies. Furthermore, the presence of anti-prothrombin antibodies was not associated with a history of pregnancy loss. Conclu sion: The result of our study shows that there is a relationship betwe en the presence of IgM anti-beta(2)-glycoprotein I and previous miscar riages in women with anti-phospholipid antibodies. (C) 1997 by The Ame rican College of Obstetricians and Gynecologists.