Association Between Maternal Anti-HPA1a Antibodies and Birth Weight of the Newborn.
Notice bibliographique
Résumé
Abstract Abstract 2405 Poster Board II-382 Background: When the mother develops antibodies against fetal platelets, fetal and neonatal alloimmune thrombocytopenia (FNAIT) can occur, with intracranial haemorrhage as the most severe complication. The frequency of FNAIT is reported to be 1:1,100 live births. The main immunogenic platelet alloantigen system in the Caucasian population is the human platelet antigen 1 (HPA1). The β3 integrin, housing the HPA1 antigen epitope on platelets, is also found on endothelial cells and invasive trophoblasts. It is therefore conceivable that maternal alloantibodies against the β3 integrin could have a direct effect on development and thereby function of the placenta. The aim of the study was to investigate whether the presence of maternal anti-HPA1a antibodies affects birth weight. Methods: We studied 74 term deliveries (≥ 37 gestational weeks) from HPA1a negative women in Norway during 1995-2008 where anti-HPA1a antibody status during pregnancy and corresponding birth weight were known. Most of the participants were selected from a prospective screening study of HPA1a negative pregnancies. Participants were also recruited from a registry in the National reference laboratory for clinical platelet immunology. The study was approved by the Regional Committee for Medical Research Ethics, North Norway. General data concerning the pregnancy and the neonate were \.{/MAIN;222}recorded. Specific data regarding maternal HPA1a immunization status included anti-HPA1a antibody levels measured during pregnancy and post partum. A linear mixed model was used to analyze the influence of maternal anti-HPA1a antibody level on the newborn birth weight. The dependent variable in the model was birth weight. Maternal age and parity, anti-HPA1a antibody level around 34 weeks of gestation, gestational age at time of delivery, sex of neonate and Apgar scores after 1 and 5 minutes were included as independent variables. All independent variables were classified as covariates with fixed effects. Since birth weights among siblings are not independent observations, the model treated each woman as one subject. Results: The mean birth weight was 3,050 grams when maternal anti-HPA1a antibodies were detected at any level or time during pregnancy (n= 47, 95% C.I. = 2952-3148). If no maternal anti-HPA1a antibodies were detected during pregnancy, the mean birth weight was 3,622 grams (n= 27, 95% C.I. = 3398-3845).We found a highly significant association between anti-HPA1a antibody levels around gestational week 34 and corresponding birth weight in the mixed model analysis, both when using antibody levels as a dichotomy variable (p = 0.006) and when dividing antibody levels into 3 intervals (no antibody detected, less than 3 IU/ml or more than 3 IU/ml, p = 0.011). Anti-HPA1a antibody level treated as a continuous variable was not significantly associated with birth weight (p = 0.057). Conclusions: We have demonstrated a significant correlation between the presence and level of maternal anti-HPA1a antibodies during pregnancy and neonatal birth weight. Our findings support the hypothesis that HPA1a alloimmunization affects more than just neonatal platelet counts, and should be considered even a placental disorder. Disclosures: No relevant conflicts of interest to declare.
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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 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 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 ».