A42: Anti‐Ro and Anti‐La Antibodies in the General Pregnant Population: Rates and Fetal Outcomes
Notice bibliographique
Résumé
Background/Purpose: Neonatal lupus erythematosus (NLE) is a passively transferred autoimmune disease that occurs in babies born to mothers with anti‐Ro and anti‐La antibodies. The most serious complication of NLE is congenital heart block (CHB). In pregnancies of mothers with a known autoimmune condition and positive anti‐Ro antibodies, the incidence of heart block is approximately 1‐2% of live births. We have previously shown that only mothers with moderate‐high titre antibodies are at risk to deliver a child with CHB. However, the rate of anti‐Ro positive antibody pregnant women in an otherwise healthy population is unknown or is their risk for delivering a child with CHB. Objectives: Determine the rate of anti‐Ro/La antibodies in the general pregnant population. Determine if the incidence of CHB is increased in healthy mothers with positive Ro/La antibodies compared to mothers with known autoimmune disease and positive anti‐Ro/La antibodies. Methods: Antibody testing was performed on 15198 pregnant women who were having concurrent Maternal Serum Screening in the Metropolitan Toronto area. Maternal self‐reported outcomes of prenatal, pregnancy, and post‐natal medical conditions were reported, along with fetal outcomes of pre and post‐natal illnesses. Autoantibody titres were stratified into negative, low, moderate, and high positive. Results: 1152/151598 (7.6%) of the mothers who had anti‐Ro antibodies and 179/15198 (1.18%) had moderate‐high titres (at risk to deliver a child with CHB). 779 (5%) had anti‐La antibodies with the majority being low titre. During the course of the study there were 13 cases of CHB that were unrelated to our maternal sample population‐ 10 to well mothers and 3 to mothers with an autoimmune disease. All of these women mothers had moderate‐high titre anti‐Ro antibodies, while only 31% had moderate‐high titre anti‐La antibodies. During the course of the study 64 pregnant women with a known autoimmune disease and anti‐Ro antibodies (at risk to deliver a child with CHB) were prospectively followed. 3/64 delivered a child with CHB. All 3 of these mothers had moderate‐high titre anti‐Ro antibodies while 41/61 mothers who delivered a child without CHB had moderate‐high titre anti‐Ro antibodies. Therefore 3/44 (6.9%) mothers with moderate‐high titre anti‐Ro antibodies and an autoimmune disease delivered a child with CHB. Conclusion: The incidence of CHB is reported to be between 1:10/N15,000 pregnancies. Therefore, based on our data showing 1.18% of otherwise well pregnant woman had moderate‐high titre anti‐Ro antibodies (at risk to deliver a child with CHB), for each child with CHB we predict that 117—174 children without CHB will be delivered to otherwise healthy mothers. In contrast, in mothers with a known autoimmune disease and moderate‐high anti‐Ro antibody titre, we found a 6.9% incidence of CHB and therefore for each child with CHB there were 14 children without CHB born. Therefore the risk for a woman with a known autoimmune disease and moderate‐high titre anti‐Ro antibodies was approximately 10x that of otherwise healthy pregnant women. These data therefore suggest that the anti‐Ro antibody repertoire differs between these 2 groups of pregnant women.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».