Are Anti-β2 Glycoprotein 1 Antibodies Associated with Placenta-Mediated Pregnancy Complications? A Nested Case-Control Study

Am J Perinatol. 2018 Sep;35(11):1093-1099. doi: 10.1055/s-0038-1641168. Epub 2018 Apr 10.

Abstract

Background: While anti-β2 glycoprotein 1 (anti-β2GP1) antibody positivity is included in the diagnostic criteria for antiphospholipid syndrome (APS), the association between anti-β2GP1 and the obstetrical complications of APS has been inconsistently reported and remains unclear.

Objective: We completed a case-control study nested within the Canadian Ottawa and Kingston (OaK) Birth Cohort to evaluate the association between anti-β2GP1 antibody positivity and placenta-mediated pregnancy complications.

Study design: Five hundred cases were randomly selected among pregnant women who experienced any of the following independently adjudicated placenta-mediated pregnancy complications: preeclampsia, placental abruption, late pregnancy loss (≥ 12 weeks' gestation), and birth of a small-for-gestational age (SGA) infant < 10th percentile. Five hundred pregnant women without any placenta-mediated pregnancy complications were selected as controls. Stored blood samples were analyzed for the presence of anti-β2GP1 antibodies by enzyme-linked immunosorbent assay.

Results: Anti-β2GP1 immunoglobulin G (IgG) and/or immunoglobulin M (IgM) antibodies in titers ≥ 20 G/M units (> 99th percentile) were present in 24 of 497 (4.8%) of controls and 33 of 503 (6.6%) of cases. There was no significant difference between cases and controls for the composite outcome of any placenta-mediated pregnancy complications (odds ratio, 1.38, 95% confidence interval [CI], 0.8-2.37, p = 0.25).

Conclusion: Our results call into question the association between anti-β2GP1 antibodies and placenta-mediated pregnancy complications, with further research needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Antiphospholipid / blood*
  • Antiphospholipid Syndrome / diagnosis
  • Antiphospholipid Syndrome / epidemiology*
  • Canada / epidemiology
  • Case-Control Studies
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Placenta Diseases / diagnosis
  • Placenta Diseases / epidemiology*
  • Pre-Eclampsia / epidemiology
  • Pregnancy
  • Pregnancy Complications / blood*
  • Pregnancy Complications / epidemiology
  • Pregnancy Outcome
  • beta 2-Glycoprotein I / immunology

Substances

  • Antibodies, Antiphospholipid
  • beta 2-Glycoprotein I