Maternal HY-restricting HLA class II alleles are associated with poor long-term outcome in recurrent pregnancy loss after a boy.
Women with secondary recurrent pregnancy loss (RPL) after a boy have a reduced chance of live birth in the first pregnancy after referral if they carry HY-restricting HLA class II alleles, but long-term chance of live birth is unknown.



Live birth was compared for 540 women with unexplained secondary RPL according to firstborn's sex and maternal carriage of HLA-DRB3*03:01, HLA-DQB1*05:01/02, HLA-DRB1*15, and HLA-DRB1*07. The groups were compared by Cox proportional hazard ratios.



For women with at firstborn boy, maternal carriage of HY-restricting HLA class II alleles decreased chance of live birth: 0 vs 1: hazard ratio 0.75 (95% CI 0.55-1.02); 0 vs 2: HR 0.62 (0.40-0.94). Carriage of HY-restricting HLA class II alleles decreased chance of live birth only if the firstborn was a boy: boy vs girl: HR 0.72 (95% CI 0.55-0.98).



Maternal carriage of HY-restricting HLA class II alleles decreases long-term chance of live birth in women with RPL after a boy.
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen Rigshospitalet, København Ø, Denmark. astrid.marie.kolte@regionh.dk.
Astrid Marie
0000-0002-8250-6798
AM
Kolte
Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.
Rudi
R
Steffensen
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen Rigshospitalet, København Ø, Denmark.|Department of Gynecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark.
Ole Bjarne
OB
Christiansen
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen Rigshospitalet, København Ø, Denmark.
Henriette Svarre
HS
Nielsen
D000026:Abortion, Habitual / Q000453:epidemiology / Q000276:immunology*; D001722:Birth Order; D002648:Child; D005260:Female; D005787:Gene Frequency; D020073:Gravidity; D006182:H-Y Antigen / Q000276:immunology*; D059866:HLA-DQ beta-Chains / Q000235:genetics / Q000378:metabolism; D059811:HLA-DRB1 Chains / Q000235:genetics / Q000378:metabolism; D006801:Humans; D008297:Male; D009035:Mothers; D011110:Polymorphism, Genetic; D011247:Pregnancy / Q000276:immunology*; D018873:Pregnancy Rate; D012306:Risk; D012723:Sex
D006182:H-Y Antigen; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D059811:HLA-DRB1 Chains
HY-restricting HLA class II alleles; cohort study; immunogenetics; recurrent pregnancy loss