What's with the boys? Lower birth weight in boys from HPA-1a alloimmunized pregnancies - New insights from a large prospective screening study in Poland.

Autor: Coucheron T; Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway., Uhrynowska M; Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Guz K; Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Orzińska A; Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Debska M; Medical Centre of Postgraduate Education, 2nd Department of Obstetrics and Gynaecology, Warsaw, Poland., Gierszon A; Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Ahlen MT; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway., Bertelsen EL; Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway., Berge G; Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway., Husebekk A; Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway., Brojer E; Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Tiller H; Department of Gynecology and Obstetrics, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway. Electronic address: heidi.tiller@unn.no.
Jazyk: angličtina
Zdroj: Journal of reproductive immunology [J Reprod Immunol] 2023 Dec; Vol. 160, pp. 104168. Date of Electronic Publication: 2023 Nov 07.
DOI: 10.1016/j.jri.2023.104168
Abstrakt: Fetomaternal incompatibility in human platelet antigens (HPAs) can cause maternal alloimmunization, which in turn may lead to thrombocytopenia with or without intracranial hemorrhage (ICH) in the fetus or newborn. Retrospective studies suggest that boys from alloimmunized mothers may have higher risk of ICH and lower birth weight than girls. The objective of this study was to assess how maternal HPA-1a alloimmunization, sex of the neonate and birth weight relates in a large prospective cohort. Through a national screening study in Poland (PREVFNAIT) involving HPA-1 typing of 24,259 pregnant women during 2013-2017, 606 HPA-1a negative pregnant women and their offspring were identified and included. Various multivariate models were used to assess if and how maternal HPA-1a alloimmunization status was associated with birth weight and risk of having a small for gestational age (SGA) neonate, and if and how sex of the neonate mattered. Most immunized pregnancies had male fetuses (69 %). Women carrying a male fetus had increased likelihood of having an SGA newborn if they were HPA-1a alloimmunized compared to non-immunized mothers. Increasing maternal anti-HPA-1a antibody levels were significantly associated with reduced birth weight and SGA risk among male-fetus pregnancies, but not if the fetus was female. In conclusion, anti-HPA-1a antibodies in a male fetus pregnancy is associated with increased risk of SGA and lower birth weight, especially if the antibody level is high. Sex of the fetus may therefore be considered as a new clinical predictor of more severe FNAIT neonatal outcome.
Competing Interests: Declaration of Competing Interest The other authors declare that they have no conflict of interest relevant to this publication.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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