title: Association of autoantibodies against the M2-muscarinic receptor with perinatal outcomes in women with severe preeclampsia.
abstract: BACKGROUND
  The goal of this study was to test the hypothesis that autoantibodies against M2-muscarinic acetylcholine receptor (M2-AAB) are associated with severe preeclampsia and increased risk of adverse perinatal outcomes.
  
  
  METHODS
  We conducted a case-control study comparing 60 women with severe preeclampsia to 60 women with normal pregnancy and 60 non-pregnant controls. A peptide, corresponding to amino acid sequences of the second extracellular loops of the M2 receptor, was synthesized as antigen to test for the presence of autoantibodies, using an enzyme-linked immunosorbent assay. The frequency and titer of M2-AAB were compared in the 3 groups. The risk of adverse perinatal outcomes among women with severe preeclampsia in the presence of M2-AAB was estimated.
  
  
  RESULTS
  M2-AAB were positive in 31.7% (19/60) of patients with severe preeclampsia, in 10.0% (6/60) (p=0.006) of normal pregnant women and in 8.3% (5/60) (p=0.002) of non-pregnant controls. The presence of M2-AAB was associated with increased risk of adverse pregnancy complications (OR, 3.6; 95%CI, 1.0-12.6; p=0.048), fetal growth restriction (OR, 6.8; 95% CI, 2.0-23.0; p=0.002), fetal distress (OR, 6.7; 95% CI, 1.7-26.6; p=0.007), low Apgar score (OR, 5.3; 95% CI, 1.4-20.7; p=0.017), and perinatal death (OR, 4.3; 95% CI, 1.0-17.6; p=0.044) among women with severe preeclampsia.
  
  
  CONCLUSIONS
  This study demonstrates, for the first time, an increase in M2-AAB in patients with severe preeclampsia. Women with severe preeclampsia who are M2-AAB positive are at increased risk for neonatal mortality and morbidity. We posit that M2-AAB may be involved in the pathogenesis of severe preeclampsia.
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Li
authors.forename: Guiling
authors.initials: G
authors.lastname: Ma
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Zhang
authors.forename: Yin
authors.initials: Y
authors.lastname: Yue
authors.forename: Yuting
authors.initials: Y
authors.lastname: Yuan
authors.forename: Yidan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Heart Failure Center, Department of Cardiology, Capital Medical University, Beijing Chao-Yang Hospital, 8# Gong-Ti South Road, 100020, Beijing, China. guobinpeking@hotmail.com.
authors.forename: Guobin
authors.initials: G
authors.lastname: Miao
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D001323:Autoantibodies / Q000276:immunology*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008969:Molecular Sequence Data; D011225:Pre-Eclampsia / Q000276:immunology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D043585:Receptor, Muscarinic M2 / Q000737:chemistry / Q000276:immunology*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D001323:Autoantibodies; D043585:Receptor, Muscarinic M2