Alpha-1 Antitrypsin Deficiency and Pregnancy

Gaeckle, Nathaniel; Stephenson, Laurel; Reilkoff, Ronald A.

doi:10.1080/15412555.2020.1754778

Cited by 13 publications

(10 citation statements)

References 44 publications

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“…Alpha-1 antitrypsin levels rise steadily throughout pregnancy such that third trimester values are approximately 2.5–6 times those preconceptions. 44 Prenatal and preimplantation diagnosis of alpha-1 antitrypsin deficiency is available, although it is not recommended as results do not predict prognosis or disease severity.…”

Section: Laboratory Investigationsmentioning

confidence: 99%

Investigating gastrointestinal disorders in pregnancy

Morton

2023

Obstet Med

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Section: Laboratory Investigationsmentioning

confidence: 99%

Investigating gastrointestinal disorders in pregnancy

Morton

2023

Obstet Med

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“…AATD affects the lungs and liver and can cause pan-acinar emphysema, premature-onset chronic obstructive pulmonary disease (COPD), and liver cirrhosis with significant heterogeneity in disease presentation. A few studies have examined pregnancy complications and birth outcomes among mothers with AATD [ 3 , 4 ], reporting that either AATD or lower levels of AAT in the serum or amniotic fluid of pregnant mothers are associated with pregnancy complications and adverse birth outcomes in the child. Adverse impacts in mothers included a deterioration in maternal respiratory function, spontaneous pneumothorax, miscarriage, and pre-eclampsia [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Alpha-1 antitrypsin deficiency and pregnancy complications and birth outcomes: A population-based cohort study in Denmark

Orimoloye,

He,

et al. 2024

PLoS ONE

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Background Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes. Objective We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD. Methods Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children. Results AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50–2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14–2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05–2.40), preterm birth (RR = 1.54, 95% CI: 1.19–2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76–3.94). Conclusions This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history.

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“…A cycle of selfrepeated inflammation and tissue damage continues if adequate AAT protection is lost. 10,11 Usually, AAT serum value rises four to six folds in pregnancy. Deficiency of AAT is an inherited metabolic disorder with variable severity and the affected women show reduced plasma levels compared to those of the healthy population.…”

Section: Introductionmentioning

confidence: 99%

Maternal alpha‐1‐antitrypsin as a noval marker for growth restriction in pre‐eclampsia

Nori

Ali

2021

J of Obstet and Gynaecol

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Aim: To verify the role of maternal serum levels of alpha-1-antitrypsin (AAT), an acute-phase inflammatory protein, as a marker for distinguishing between fetal growth restriction (FGR) and normal birth weight in pre-eclamptic women. We correlate serum AAT levels to the essential feto-maternal parameters for an earlier and cost-benefit diagnostic method, thus distinguishing between FGR and normal birth weight in preeclamptic women. Methods: An observational study conducted at the University hospital recruited 100 pregnant women in 32/34 weeks of a singleton single tone pregnancy; all were pre-eclampsia cases. All were tested by laboratory and ultrasound examination. Two sets of data were collected; one is maternal parameters such as blood pressure (BP), maternal serum AAT mean platelet volume (MPV), platelet distribution width (PDW), and serum uric acid levels, and the other is fetal parameters such as amniotic fluid index (AFI), fetal weight centile and estimated fetal weight. Results: A strong negative correlation proved between serum levels of AAT and all study variables except fetal weight (systolic BP, diastolic BP, MPV, PDW, serum uric acid, fetal weight percentile, and AFI) with a correlation coefficient of; À0.95, À0.95, À0.85, À0.93, À0.91, À0.94, and À0.93 respectively. The cut-off value for AAT 0.013 mg/ml showed the highest sensitivity and specificity as a diagnostic marker for FGR. Area under the curve was 0.99. Conclusions: Negative correlations between maternal serum AAT and fetal parameters used to assess FGR were confirmed, suggesting that AAT is closely related to the pathophysiology of FGR among pre-eclamptic patients and may serve as a helpful tool in distinguishing between FGR and normal birth weight babies, pending further validation in feto-maternal outcomes.

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Alpha-1 Antitrypsin Deficiency and Pregnancy

Cited by 13 publications

References 44 publications

Investigating gastrointestinal disorders in pregnancy

Investigating gastrointestinal disorders in pregnancy

Alpha-1 antitrypsin deficiency and pregnancy complications and birth outcomes: A population-based cohort study in Denmark

Maternal alpha‐1‐antitrypsin as a noval marker for growth restriction in pre‐eclampsia

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