Diagnostic significance of autoantibody combination in fetal growth restriction with early and late manifestation

Abstract

BACKGROUND: Fetal growth restriction (FGR) is one of the current problems in modern obstetrics and perinatology, which is associated with a large number of adverse perinatal outcomes.

AIM: This study aimed to assess the diagnostic significance of the combination of autoantibodies (AAB) in the early and late FGR manifestation.

MATERIALS AND METHODS: The study involved 117 pregnant women, classified into Group 1 (90 women with FGR) and Group 2 (27 women with a physiological course of pregnancy). Pregnant women with FGR were divided into two subgroups depending on the time of manifestation, i.e. FGR subgroups with early and late manifestation (45 patients each), respectively. Upon hospital admission, all patients of the study groups had blood sampling to determine autoimmune AABs using the ELI-P-test.

RESULTS: An isolated increase in AABs to human chorionic gonadotropin (hCG) antigen, TrM (AAB markers of changes in vascular and hemostasis system), S100 protein, antineutrophil cytoplasm antibodies (ANCA), and KiMS (AABs to the cytoplasmic antigen of glomerular kidney cells) were observed in the early FGR manifestation when comparing the abnormal AAB spectrum in the early and late FGR manifestation, while a statistically significant isolated increase in the level of AABs to DNA and insulin was found in the late FGR manifestation.

CONCLUSIONS: The study revealed the diagnostic significance of AAB combinations, as well as the combinations of increased AAB levels to hCG, S100, ANCA, and KiMS and an increase in AABs to DNA, collagen, and S100 protein in the early and late FGR manifestation, respectively.

Keywords

fetal growth restriction with early manifestation / fetal growth restriction with late manifestation / autoimmune autoantibodies / ELI-P-test

References

[1] Nardozza L, Caetano A, Zamarian A, et al. Fetal growth restriction: current knowledge. Arch Gynecol Obstet. 2017;295(5):1061–1077. doi: 10.1007/s00404-017-4341-9

[2] Nardozza L., Caetano A., Zamarian A., et al. Fetal growth restriction: current knowledge // Arch Gynecol Obstet. 2017. Vol. 295, N 5. P. 1061–1077. doi: 10.1007/s00404-017-4341-9

[3] Marzouk A, Filipovic-Pierucci A, Baud O, et al. Prenatal and post-natal cost of small for gestational age infants: a national study. BMC Health Serv Res. 2017;17(1):221. doi: 10.1186/s12913-017-2155-x

[4] Marzouk A., Filipovic-Pierucci A., Baud O., et al. Prenatal and postnatal cost of small for gestational age infants: a national study // BMC Health Serv Res. 2017. Vol. 17, N 1. P. 221. doi: 10.1186/s12913-017-2155-x

[5] Gallego EM, Pujol AT, Bartra AJC, Roig MDG. Fetal Growth Restriction. In: Ahmed RG, Ahmet U, editors. Growth Disorders and Acromegaly. Open access peer-reviewed chapter. 2020. Available from: https://www.intechopen.com/chapters/70711

[6] Gallego E.M., Pujol A.T., Bartra A.J.C., Roig M.D.G. Fetal Growth Restriction. In: Ahmed R.G., Ahmet Ucar, editors. Growth Disorders and Acromegaly. Open access peer-reviewed chapter. 2020. Режим доступа: https://www.intechopen.com/chapters/70711. Дата обращения: 10.12.2021.

[7] Volochaeva MV, Baev OR. Current views on the pathogenesis of fetal growth restriction. Obstetrics and Gynecology. 2021;8:13–17. (In Russ). doi: 10.18565/aig.2021.8.13-17

[8] Волочаева М.В., Баев О.Р. Современные представления о патогенезе задержки роста плода // Акушерство и гинекология. 2021. Т. 8. С. 13–17. doi: 10.18565/aig.2021.8.13-17

[9] Russian Society of Obstetricians and Gynecologists. Nedostatochnyi rost ploda, trebuyushchii predostavleniya meditsinskoi pomoshchi materi (zaderzhka rosta ploda). Clinical recommendations. Ministry of Health of the Russian Federation; 2022. Available from: 2022 КР МЗ РФ Недостаточный рост плода (ЗРП).pdf. (In Russ).

[10] Российское общество акушеров-гинекологов. Недостаточный рост плода, требующий предоставления медицинской помощи матери (задержка роста плода). Клинические рекомендации. Минздрав РФ, 2022. Режим доступа: 2022 КР МЗ РФ Недостаточный рост плода (ЗРП).pdf. Дата обращения: 01.11.2022.

[11] Gordijn SJ, Beune IM, Thilaganathan B, et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol. 2016;48(3):333–339. doi: 10.1002/uog.15884

[12] Gordijn S.J., Beune I.M., Thilaganathan B., et al. Consensus definition of fetal growth restriction: a Delphi procedure // Ultrasound Obstet Gynecol. 2016. Vol. 48, N 3. P. 333–339. doi: 10.1002/uog.15884

[13] Russian Society of Obstetricians and Gynecologists, Association of Anesthesiologists and Resuscitators, Obstetrical Anesthesiologists and Intensivist Association. Preeklampsiya. Eklampsiya. Oteki, proteinuriya i gipertenzivnye rasstroistva vo vremya beremennosti, v rodakh i poslerodovom periode. Clinical recommendations. Ministry of Health of the Russian Federation; 2021. Available from: https://cr.minzdrav.gov.ru/schema/637_1. (In Russ).

[14] Российское общество акушеров-гинекологов, Ассоциация анестезиологов-реаниматологов, Ассоциация акушерских анестезиологов-реаниматологов. Преэклампсия. Эклампсия. Отеки, протеинурия и гипертензивные расстройства во время беременности, в родах и послеродовом периоде. Клинические рекомендации. Минздрав РФ, 2021. Режим доступа: https://cr.minzdrav.gov.ru/schema/637_1. Дата обращения: 01.11.2022.

[15] Aviram A, Sherman C, Kingdom J, et al. Defining early vs late fetal growth restriction by placental pathology. Acta Obstet Gynecol Scand. 2019;98(3):365–373. doi: 10.1111/aogs.13499

[16] Aviram A., Sherman C., Kingdom J., et al. Defining early vs late fetal growth restriction by placental pathology // Acta Obstet Gynecol Scand. 2019. Vol. 98, N 3. P. 365–373. doi: 10.1111/aogs.13499

[17] Dubossarskaya ZM, Duka YM. Role of gene polymorphisms in genesis of gestational complications at pregnant women with obesity. Obstetrics, gynecology and reproduction. 2016;3:18–23. (In Russ). doi: 10.17749/2313-7347.2016.10.2.018-023

[18] Дубоссарская З.М., Дука Ю.М. Опыт ведения беременности при сенсибилизации к хорионическому гонадотропину человека // Акушерство, гинекология и репродукция. 2016. Т. 3. С. 18–23. doi: 10.17749/2313-7347.2016.10.2.018-023

[19] Kemppinen L, Mattila M, Ekholm E, et al. Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections. J Perinat Med. 2020;49(4):431–438. doi: 10.1515/jpm-2020-0379

[20] Kemppinen L., Mattila M., Ekholm E., et al. Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections // J Perinat Med. 2020. Vol. 49, N 4. P. 431–438. doi: 10.1515/jpm-2020-0379

RIGHTS & PERMISSIONS

Yakubova D.I., Ignatko I.V., Megrabyan A.D., Silaeva T.M., Bogomazova I.M.