IgA deficiency, autoimmunity & pregnancy: a population-based matched cohort study.

Abstract:

BACKGROUND:Several autoimmune disorders have been linked to adverse pregnancy outcome. IgA deficiency shares many autoimmune traits, but its association with pregnancy outcome is unknown. METHODS:Prospective population-based cohort study in Sweden of 613 mothers with IgA deficiency (IgA levels < .07 g/L) diagnosed in 1980-2010 in six university hospitals. In 1973-2010, these women delivered 1,172 singleton infants registered in the Swedish Medical Birth Register. Each delivery to a woman with IgA deficiency was matched on maternal age, parity, early pregnancy smoking status, education level, and delivery year with up to 5 control births (n = 5,758). RESULTS:Offspring to women with IgA deficiency had 79 g lower birth weight than controls (mean ± SD: 3,457 ± 559 vs 3,537 ± 553 g, P < 0.001), and 1.4 days shorter gestational age (mean ± SD: 278 ± 13 vs 280 ± 14 days, P = 0.001). No difference in preterm birth (<37 weeks) could be detected in deliveries to women with IgA deficiency vs control deliveries (5.8 % vs 5.2 %; odds ratio (OR) = 1.13, 95%CI = 0.85-1.49), but small for gestational age birth was more common (4.3 % vs 2.8 %; OR = 1.48, 95%CI = 1.04-2.10). Women with IgA deficiency also delivered more often by caesarean section (16.9 % vs 11.9 %; OR = 1.51, 95%CI = 1.26-1.82), while no difference was observed regarding low Apgar score (<7 at 5 min; 1.1 % vs 1.0 %; OR = 1.18; 95%CI = 0.62-2.27). When excluding women with autoimmune diseases, the excess risks of adverse pregnancy outcome diminished. CONCLUSION:There is a small excess risk of certain adverse delivery and perinatal outcomes among offspring to women with IgA deficiency. These excess risks are attenuated when considering the presence of autoimmune diseases.

journal_name

J Clin Immunol

authors

Ludvigsson JF,Neovius M,Stephansson O,Hammarström L

doi

10.1007/s10875-014-0069-5

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

853-63

issue

7

eissn

0271-9142

issn

1573-2592

journal_volume

34

pub_type

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