The study of types and titers of anti-cardiolipin antibodies in women with adverse pregnancy outcomes

Abstract

Objective: Anti-cardiolipin antibodies (aCL) associated with various obstetric complications and subject to thrombosis of placental vessels. aCL associated with thrombosis does not directly bind to CL itself, but to b₂-glycoprotein I (b₂-GP I) which attached to CL. Our purpose was to study the actions of aCL and anti-cardiolipin b₂-glycoprotein I complex antibodies (anti-CEb₂-GP I) on pregnancy outcomes.

Full Text

Methods: Sera from 80 pregnant women with adverse pregnancy outcomes (recurrent miscarriages, intrauterine dearth, severe preeclampsia and IUGR) were detected on presence of aCL and anti-CL b₂-GP I by enzyme-linked immunosorbent assays (ELISA kits, YAMASA). The diagnosis “placental insufficiency” was certified morphologically in all patients.

Results: anti-CEb₂-GP I in low and moderate titers (1,3-8,0 Units/ml) was detected in 10%, in high titer — 50 U/ml in 1,25% of women, a CL in low and moderate titers — in 29% and in high titers — in 9% of women. In the half of women with low or moderate titers of anti-CEb₂-GP I were other symptoms of anti-phospholipid syndrome — thrombocytopenia and livedo reticularis. In one woman with high titer of anti-CE b₂-GP I ileo-femoral thrombosis was occur on 31 week of pregnancy. Among women with aCL in low and moderate titers viral and streptococcal infections was found in majority of cases. Only one of high titer aCLs women has lupus-like disease. None of other patients fulfilled the diagnostic criteria for autoimmune diseases and had any history of thrombosis. Among women with anti-CLb₂-GP I most pregnancies ended by miscarriage and intrauterine dearth in II-III trimesters. Most characteristic complications of pregnancy among women with a CL were severe preeclampsia and IUGR.

Conclusions: Therefore, the adverse pregnancy outcomes can be connected both with anti-CLb₂-GP I and with aCL and depends a little from the titer of antibodies. The underlying mechanisms of actions of different types of aCL on placental function required the further elucidation’s.