PMID- 23841577
OWN - NLM
STAT- MEDLINE
DCOM- 20131119
LR  - 20240321
IS  - 1600-0897 (Electronic)
IS  - 1046-7408 (Print)
IS  - 1046-7408 (Linking)
VI  - 70
IP  - 2
DP  - 2013 Aug
TI  - Detection of anti-HLA antibodies in maternal blood in the second trimester to 
      identify patients at risk of antibody-mediated maternal anti-fetal rejection and 
      spontaneous preterm delivery.
PG  - 162-75
LID - 10.1111/aji.12141 [doi]
AB  - PROBLEM: Maternal anti-fetal rejection is a mechanism of disease in spontaneous 
      preterm labor. The objective of this study was to determine whether the presence 
      of human leukocyte antigen (HLA) panel-reactive antibodies (PRA) during the 
      second trimester increases the risk of spontaneous preterm delivery. METHODS OF 
      STUDY: This longitudinal case-control study included pregnant women with 
      spontaneous preterm deliveries (n = 310) and control patients with normal term 
      pregnancies (n = 620), matched for maternal age and gravidity. Maternal plasma 
      samples obtained at 14-16, 16-20, 20-24, and 24-28 weeks of gestation were 
      analyzed for HLA class I and class II PRA positivity using flow cytometry. The 
      fetal HLA genotype and maternal HLA alloantibody epitope were determined for a 
      subset of patients with positive HLA PRA. RESULTS: (i) Patients with spontaneous 
      preterm delivery were more likely to exhibit HLA class I (adjusted OR = 2.54, P < 
      0.0001) and class II (adjusted OR = 1.98, P = 0.002) PRA positivity than those 
      delivering at term; (ii) HLA class I PRA positivity for patients with spontaneous 
      preterm delivery between 28 and 34 weeks (adjusted OR = 2.88; P = 0.001) and 
      after 34 weeks of gestation (adjusted OR = 2.53; P < 0.0001) was higher than for 
      those delivering at term; (iii) HLA class II PRA positivity for patients with 
      spontaneous preterm delivery after 34 weeks of gestation was higher than for 
      those delivering at term (adjusted OR = 2.04; P = 0.002); (iv) multiparous women 
      were at a higher risk for HLA class I PRA positivity than nulliparous women 
      (adjusted OR = 0.097, P < 0.0001 for nulliparity); (v) nulliparous women had a 
      higher rate of HLA class I PRA positivity with advancing gestational age (P = 
      0.001); and (vi) 78% of women whose fetuses were genotyped had alloantibodies 
      specific against fetal HLA class I antigens. CONCLUSION: Pregnant women with 
      positive HLA class I or class II PRA during the second trimester are at an 
      increased risk of spontaneous preterm delivery due to antibody-mediated maternal 
      anti-fetal rejection.
CI  - Published 2013. This article is a US Government work and is in the public domain 
      in the USA.
FAU - Lee, JoonHo
AU  - Lee J
AD  - Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, USA.
FAU - Romero, Roberto
AU  - Romero R
FAU - Xu, Yi
AU  - Xu Y
FAU - Miranda, Jezid
AU  - Miranda J
FAU - Yoo, Wonsuk
AU  - Yoo W
FAU - Chaemsaithong, Piya
AU  - Chaemsaithong P
FAU - Kusanovic, Juan Pedro
AU  - Kusanovic JP
FAU - Chaiworapongsa, Tinnakorn
AU  - Chaiworapongsa T
FAU - Tarca, Adi L
AU  - Tarca AL
FAU - Korzeniewski, Steven J
AU  - Korzeniewski SJ
FAU - Hassan, Sonia S
AU  - Hassan SS
FAU - Than, Nandor Gabor
AU  - Than NG
FAU - Yoon, Bo Hyun
AU  - Yoon BH
FAU - Kim, Chong Jai
AU  - Kim CJ
LA  - eng
GR  - ZIA HD002400-22/ImNIH/Intramural NIH HHS/United States
GR  - HHSN275201300006C/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PL  - Denmark
TA  - Am J Reprod Immunol
JT  - American journal of reproductive immunology (New York, N.Y. : 1989)
JID - 8912860
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Histocompatibility Antigens Class II)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antibodies/*blood/immunology
MH  - Case-Control Studies
MH  - Female
MH  - Fetus/*immunology
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Antigens Class I/blood/immunology
MH  - Histocompatibility Antigens Class II/blood/immunology
MH  - Humans
MH  - Infant, Newborn
MH  - Isoantibodies/blood/immunology
MH  - Middle Aged
MH  - Pregnancy
MH  - Pregnancy Trimester, Second/*blood
MH  - Premature Birth/*immunology
MH  - Young Adult
PMC - PMC4154511
MID - NIHMS622522
OTO - NOTNLM
OT  - Flow cytometry
OT  - preterm birth
OT  - rejection
OT  - transplantation
EDAT- 2013/07/12 06:00
MHDA- 2013/11/20 06:00
PMCR- 2014/09/04
CRDT- 2013/07/12 06:00
PHST- 2013/04/17 00:00 [received]
PHST- 2013/04/30 00:00 [accepted]
PHST- 2013/07/12 06:00 [entrez]
PHST- 2013/07/12 06:00 [pubmed]
PHST- 2013/11/20 06:00 [medline]
PHST- 2014/09/04 00:00 [pmc-release]
AID - 10.1111/aji.12141 [doi]
PST - ppublish
SO  - Am J Reprod Immunol. 2013 Aug;70(2):162-75. doi: 10.1111/aji.12141.