PREVALENCE OF ELEVATED ANTICARDIOLIPIN ANTIBODIES IN PREGNANT-WOMEN WITH UNEXPLAINED ELEVATIONS OF ALPHA-FETOPROTEIN

The goal was to determine what proportion of pregnant women with unexp lained elevations of maternal serum alpha-fetoprotein (MSAFP) have inc reased levels of anticardiolipin antibodies (ACA), and if this might e xplain the increased prevalence of adverse pregnancy outcomes. Materna l serum alpha-fetoprotein levels of 12295 pregnant women were evaluate d at 15-19.5 gestational weeks. Elevated readings (> 2.5 MOM) were ide ntified in 190 women (1.5%) and 86 (0.7%) of these had unexplained cau ses. Specimens (80) were recovered and ACA levels for cardiolipin were determined using enzyme-linked immunosorbant assay. Positive IgG ACA were identified in 10 out of 80 cases (12.5%) of elevated MSAFP; 3 out of 80 cases (3.8%) had positive IgM ACA. The control women with norma l MSAFP levels had positive IgG ACA in 3 of 86 cases (3.5%) and 1 of 8 6 cases (1.2%) for IgM. Women with increased MSAFP and positive ACA ha d infants with an average birth weight of 2684 +/- 889 g compared to 2 793 +/- 847 g in women with increased MSAFP and normal ACA. No signifi cant differences in Ige ACA were found in pregnant women with unexplai ned elevated MSAFP (10/80, 12.5%) compared to women with normal MSAFP (3/86, 3.5%). As expected, lower birth weight was identified in women who had elevated MSAFP (2738 +/- 868 g) vs. women with normal MSAFP 31 81 +/- 1082 g (P = 0.004), independent of ACA positivity. (C) 1997 Els evier Science Ireland Ltd.