Antiphospholipid/antiprotein antibodies, hemostasis-related autoantibodies, and plasma homocysteine as risk factors for a first early pregnancy loss: a matched case-control study.
Maternal hypercoagulability is a possible cause of miscarriage during the eighth and ninth weeks of pregnancy, when the placenta replaces the yolk sac. We thus examined associations between putative markers of an acquired hypercoagulable state and the risk of first miscarriage. We conducted a case-control study comparing 743 women who miscarried in weeks 8 and 9 with 743 women who underwent a first provoked abortion, matched for age, number of pregnancies, and time elapsed since abortion. Levels of plasma homocysteine and of various antiphospholipid/antiprotein and hemostasis-related autoantibodies were categorized in 4 strata (percentiles 1-80, 81-95, 96-99, 100 among control patients) and analyzed in conditional logistic regression models. Pregnancy loss was independently associated with positive lupus anticoagulant (matched odds ratio [OR], 2.6; 95% confidence interval [CI], 1.1-6.0), high levels of immunoglobulin M (IgM) antibodies against cardiolipin (OR for percentile 100 versus 0-80, 3.5; CI, 1.2-10.1) and against phosphatidylethanolamine (OR, 4.7; CI, 1.9-12.1), high levels of IgG antibodies against annexin V (OR, 3.2; CI, 1.1-9.1) and against tissue-type plasminogen activator (OR, 19.5; CI, 7.9-48.0), and high homocystinemia (OR, 4.1; CI, 1.3-12.5). A first early pregnancy loss is associated with increased levels of several autoantibodies and of homocysteine.
Gris
Jean-Christophe
JC
Haematology Laboratory, University Hospital, F-30029 Nimes cedex 9, France. jcgris@chu-nimes.fr
Perneger
Thomas V
TV
Quéré
Isabelle
I
Mercier
Eric
E
Fabbro-Peray
Pascale
P
Lavigne-Lissalde
Géraldine
G
Hoffet
Médéric
M
Déchaud
Hervé
H
Boyer
Jean-Christophe
JC
Ripart-Neveu
Sylvie
S
Tailland
Marie-Laure
ML
Daurès
Jean-Pierre
JP
Marès
Pierre
P
Dauzat
Michel
M
D000022:Abortion, Spontaneous / Q000097:blood* / Q000209:etiology; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D006487:Hemostasis / Q000276:immunology*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D016555:Matched-Pair Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012307:Risk Factors
D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D015415:Biomarkers; D001779:Blood Coagulation Factors; D006710:Homocysteine