The prevalence of autoantibodies during third-trimester pregnancy complicated by hypertension or idiopathic fetal growth retardation

Article Abstract:

Autoantibodies are proteins produced by the immune system that have an affinity for one's own tissues. They are thought to be involved in a number of complications that occur during pregnancy. They are seen in normal pregnant women as well as in those that have complications. This study examined whether the prevalence of certain types of autoantibodies was different in pregnancies complicated by hypertension or fetal growth retardation and those that were normal. Autoantibodies were measured in 200 pregnant women, 100 who had known complications and 100 who had normal pregnancies. Of the 100 who had complications, 50 involved hypertension and 50 involved fetal growth retardation. Standard tests for blood coagulation were normal in all the subjects, indicating that lupus anticoagulant, which prevents normal blood coagulation, was not present. In women with normal pregnancies, no lupus anticoagulant or anticardiolipin antibodies were found. Three patients (3 percent) tested positive for specific autoantibodies against cell components. One of the 50 women in the fetal growth-retardation group tested positive for lupus anticoagulant. Eight women in the hypertension group tested positive for autoantibodies, including four testing positive for lupus anticoagulant, two testing positive for anticardiolipin antibodies, and three testing positive for autoantibodies against cell components. One patient tested positive for two types. The prevalence of autoantibodies was similar between underlying causes of the hypertension. The eight patients with hypertension and antibodies had significantly more pregnancies involving fetal growth retardation (6 of 8, or 75 percent) than did those with hypertension and no antibodies (8 of 28 or 28 percent). These results indicate that women with hypertension and a history of fetal growth retardation should be tested for autoantibodies. If they are present, no specific treatment is recommended, but the women should be monitored for the development of autoimmune disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Autoantibodies, Autoimmune diseases

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Proteinuria and outcome of 444 pregnancies complicated by hypertension

Article Abstract:

High blood pressure during pregnancy can cause fetal growth retardation or even fetal death. The loss of protein into the urine, a condition known as proteinuria, depends on the type of disease causing the high blood pressure. Proteinuria is associated with a poor fetal outcome. The relationship between proteinuria, the source of the high blood pressure and the birthweight of the fetus was studied in 444 single-fetus pregnancies. There were 98 patients with chronic high blood pressure (documented before pregnancy or before the 20th week of pregnancy), 199 with pregnancy-induced high blood pressure and proteinuria and 147 with preeclampsia (a condition of pregnancy causing high blood pressure, swelling and proteinuria). The greater the proteinuria, the poorer the pregnancy outcome. In the group with preeclampsia and proteinuria, 52 percent of the fetuses were small for gestational age (SGA, smaller than expected for that fetal age). SGA fetuses accounted for 18 percent of the patients with high blood pressure without proteinuria and 12 percent of the patients with chronic high blood pressure. There was no adverse fetal outcome in the patients with chronic high blood pressure. Fetal death rate was 129 out of 1,000 fetuses born to mothers having proteinuric preeclampsia. The fetal death rate was four times higher in infants born to mothers having proteinuric preeclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Preeclampsia, Proteinuria

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Macrosomia: influence of maternal overweight among a low-income population

Article Abstract:

Fetal birth weight greater than 8.8 pounds (4,000 grams), macrosomia, can be associated with a difficult, risky birth and fetal death. Large infants are commonly born to obese mothers. Obesity is a common health problem in low-income populations. To see if other socioeconomic factors contribute to macrosomia, women were divided into five different groups, depending on body mass index (a calculation based on a ratio of weight/height) percentiles. The percentile ranged from less than the 25th percentile, 25th to 75th percentile, 75th to less than 85th percentile, 85th to 95th percentile and over the 95 percentile. Macrosomia was found in five percent of the women with body mass index in the less-than-25th percentile group and 17 percent in the highest body mass percentile. The chance of an overweight woman having a macrosomic infant was 2.2 times higher than normal pregnant women. After adjusting for the age of the mother, smoking status, race, height, the number of previous pregnancies, the gestational age of the infant, and sex of the infant, maternal weight remained a significant factor influencing the development of macrosomia. To prevent the incidence of macrosomia, programs should be designed to help reduce to the weight of low-income women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Obesity, Pregnant women, Fetal macrosomia

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