Recurrent pregnancy loss and autoantibody profile in autoimmune diseases

Objective. To explore the association of non-organ-specific autoimmune resp onses against three distinct Ro antigen-related reactivities (Ro52, Ro60, p 57) with a history of pregnancy loss in women with autoimmune disorders. Materials and methods. Seventy unselected anti-Ro/SSA-positive women were s tudied in a retrospective cohort study. Forty anti-Ro/SSa-positive women we re age matched to an equal number of women with autoimmune disorders who we re anti-Ro/SSA negative in a case-control study. The association of reactiv ities against three distinct antigen specificities (Ro52, Ro60, p57) with r ecurrent pregnancy loss was investigated. Independence and modification of these associations from the effect of antithyroglobulin, antithyroid peroxi dase and anticardiolipin antibodies were also examined. Results. In the cohort study, reactivity against each of the three antigen specificities (Ro52, Ro60, p57) was independently associated with a history of recurrent pregnancy loss. In the case-control study, the effects were s till independent and were not modified when other autoantibodies were consi dered. In particular, the number of reactivities against Ro52, Ro60 and p57 peptides, and the presence of antithyroglobulin antibodies, were independe nt predictors of recurrent pregnancy loss (odds ratios 3.35 per each additi onal reactivity and 5.54 in the presence of antithyroglobulin; P = 0.002 an d 0.025, respectively). Conclusions. In women with autoimmune disorders, a history of recurrent pre gnancy loss is independently associated with reactivity against each of the three antigen specificities (Ro52, Ro60, p57) and also with the presence o f antithyroglobulin antibodies, suggesting that cumulative autoimmune respo nses against these non-organ-specific and organ-specific antigens correlate with the risk of stillbirth and spontaneous abortion.