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IgA Deficiency, Autoimmunity & Pregnancy: A Population-Based Matched Cohort Study
Örebro University Hospital. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-1024-5602
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Women’ s and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Laboratory Medicine, Karolinska Institutet, Solna, Sweden.
2014 (English)In: Journal of Clinical Immunology, ISSN 0271-9142, E-ISSN 1573-2592, Vol. 34, no 7, 853-863 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Springer, 2014. Vol. 34, no 7, 853-863 p.
Keyword [en]
Autoimmune, childbirth, IgA deficiency, immunoglobulin, pregnancy, perinatal outcomes
National Category
Immunology in the medical area
Research subject
Immunology
Identifiers
URN: urn:nbn:se:oru:diva-37866DOI: 10.1007/s10875-014-0069-5ISI: 000342212000015PubMedID: 25005830Scopus ID: 2-s2.0-84903801534OAI: oai:DiVA.org:oru-37866DiVA: diva2:757465
Funder
Swedish Research Council
Note

Funding Agencies:

Swedish Society of Medicine

Stockholm County council

Karolinska Institutet

Available from: 2014-10-22 Created: 2014-10-20 Last updated: 2017-10-18Bibliographically approved

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