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Am J Perinatol 2018; 35(11): 1093-1099
DOI: 10.1055/s-0038-1641168
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Leslie Skeith
1   Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
2   Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
,
Karim E. Abou-Nassar
3   Service d'Hématologie et Axe de Recherche en Cancérologie, Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Gatineau, Quebec, Canada
,
Mark Walker
2   Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
4   Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
,
Tim Ramsay
2   Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
,
Ronald Booth
2   Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
,
Shi Wu Wen
2   Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
4   Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
,
Graeme N. Smith
5   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
,
Marc A. Rodger
2   Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
4   Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
6   Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
› Author Affiliations
Funding The OaK Birth Cohort study was funded by the Canadian Institutes of Health Research (CIHR grants # MOP 64461, MOP 82802 and MOP 53188). L.S. is the recipient of a CanVECTOR Research Fellowship award. K.E.A.-N. is the recipient of a Physicians Services Incorporated resident research grant. M.A.R. is the recipient of a Heart and Stroke Foundation Career Investigator Award (CI6225 and CI7441) and a University of Ottawa Faculty of Medicine Clinical Research Chair in Venous Thrombosis and Thrombophilia. M.W. is supported by a University of Ottawa Tier 1 Chair in Perinatal Epidemiology.
Further Information

Publication History

01 October 2017

23 February 2018

Publication Date:
10 April 2018 (online)

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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.

Keywords

antiphospholipid antibodies - antiphospholipid syndrome - pregnancy complications - placenta diseases - pregnancy outcome

Authors' Contributions

L.S. analyzed and interpreted data, performed statistical analysis, and wrote the first draft of the manuscript. K.E. A.-N. designed the research, analyzed and interpreted data, performed statistical analysis, and prepared the data tables. M.A.R. designed the research, collected data, analyzed and interpreted data, and performed statistical analysis. M.W. designed the research, collected data, analyzed and interpreted data, and performed statistical analysis. T.R. designed the research, analyzed, and interpreted data. R.B. designed the research and collected data. S.W.W. designed the research, collected data, analyzed and interpreted data, and performed statistical analysis. G.N.S. designed the research, collected data, analyzed and interpreted data, and performed statistical analysis. All authors reviewed drafts of the manuscript and approved the final draft of the manuscript.