Antiphosphatidyl serine antibodies are more common in normotensive women with small for gestational age pregnancies.
BACKGROUND
Small for gestational age (SGA) babies are more common in women with antiphospholipid antibodies but data are limited about the prevalence of antiphospholipid antibodies in women who have delivered SGA babies.


OBJECTIVE
To determine whether elevated levels of anticardiolipin, antiphosphatidyl serine and/or antibeta2 glycoprotein I antibodies are more common in normotensive women who delivered SGA babies compared with women who delivered appropriate for gestational age babies.


METHODS
Case-control study. Cases were normotensive women who delivered an SGA baby (birthweight <10th%) without chromosomal or congenital abnormality. Controls were healthy women who delivered a baby at term with birthweight >10th percentage.


RESULTS
A total of 137 women with SGA pregnancies and 290 controls had antiphospholipid antibodies measured. The prevalence of anticardiolipin and antibeta2 glycoprotein I antibodies did not differ between SGA cases and controls. Antiphosphatidyl serine IgG antibodies were more common in women with SGA pregnancies than controls seven (5%) versus five (1.7%), relative risk (RR) 1.84 (1.12-3.03). There was no difference in the prevalence of 'any antiphospholipid antibodies' between SGA 10 (7.2%) and controls 16 (5.6%). There was a trend to more abnormal umbilical Doppler studies in SGA pregnancies with positive antiphospholipid antibodies three (50%) versus 19 (24%), RR 2.9 (0.62-13).


CONCLUSIONS
Antiphospholipid antibodies were uncommon in this cohort of SGA pregnancies. Further studies are needed in SGA pregnancies with abnormal umbilical Doppler studies to determine if screening for antiphospholipid antibodies is worthwhile in this severe subgroup.
McCowan
Lesley M E
LM
Department of Obstetrics and Gynaecology, National Women's Hospital, University of Auckland, Auckland, New Zealand. l.mccowan@auckland.ac.nz
Chamley
Larry W
LW
D017152:Antibodies, Antiphospholipid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood* / Q000276:immunology; D016014:Linear Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012694:Serine / Q000097:blood; D016216:Ultrasonography, Prenatal
D017152:Antibodies, Antiphospholipid; D015415:Biomarkers; D012694:Serine