The prognostic value of anti-paternal antibodies and leukocyte immunizations on the proportion of live births in couples with consecutive recurrent miscarriages

Citation
S. Orgad et al., The prognostic value of anti-paternal antibodies and leukocyte immunizations on the proportion of live births in couples with consecutive recurrent miscarriages, HUM REPR, 14(12), 1999, pp. 2974-2979
Citations number
32
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
HUMAN REPRODUCTION
ISSN journal
0268-1161 → ACNP
Volume
14
Issue
12
Year of publication
1999
Pages
2974 - 2979
Database
ISI
SICI code
0268-1161(199912)14:12<2974:TPVOAA>2.0.ZU;2-2
Abstract
Anti-paternal antibodies directed towards paternal leukocytes have been use d to predict the prognosis for the subsequent pregnancy in women with conse cutive recurrent miscarriages (CRM) and also to determine if the patient ha s become immune after paternal leukocyte immunization. The predictive value is controversial, as these antibodies are not essential for pregnancy to d evelop, and only occur in a minority of parous women. This study tried to d etermine the predictive value of these antibodies when assessed separately for women with five or more abortions and compared to women with three or f our abortions. The patients were assessed separately so that the higher liv e birth rate in the latter group would not obscure meaningful results in th e former group with a poor prognosis. Antibody production, whether spontane ous, or induced by immunization, raised the live birth rate in primary and tertiary aborters with three, four, five or more abortions. Antipaternal an tibodies increased the proportion of live births from 18.5 to 53.7% (P less than or equal to 0.01) and from 44.3 to 67.5% (P less than or equal to 0.0 01) in primary aborters with greater than or equal to 5 CRM and 3-4 CRM res pectively. Both immunization with paternal leukocytes per se and the abilit y to express anti-paternal antibodies were associated with an increased pro portion of live births in the next pregnancy. Multivariate analysis showed that that the odds ratio for a live birth was approximately four times grea ter in women who were immunized and produced anti-paternal antibodies than in control patients. The lack of anti-paternal antibodies at initial testin g could serve as a marker for the benefit of immunization with paternal leu kocytes; the subsequent presence as a prognostic marker for the subsequent pregnancy.