Maternal-Fetal Immune Relationship: Another Point of View

Vliet, J. Husson-van; Druyts-Voets, E.

doi:10.1159/000461850

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…We observed a decrease of albumin concentration ranging from 0% before the 15th week [correction factor (CF) = 1] to 35% (CF = 1.35) at 39 weeks, according to the linear function CF =0.0146 t + 0.7813, where t is the term of gestation (data not shown). This is in accordance with reported results [21]. Therefore, the maternal antibody concentrations are given in AU mL −1 taking into account the gestational hemodilution factor.…”

Section: Methodssupporting

confidence: 91%

“…The present study also gives insight into the evolution of the maternal antibody concentration during pregnancy. Whatever the maternal therapy for the following pregnancy, we observed an absolute decrease of the anti‐HPA‐1a concentration, independently of the hemodilution phenomenon [20,21]. We observed a significant drop in concentration by the end of pregnancy and the antibody amounts became too low for a precise quantification and establishment of a correlation with clinical data.…”

Section: Discussionmentioning

confidence: 90%

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Predictive value of sequential maternal anti‐HPA‐1a antibody concentrations for the severity of fetal alloimmune thrombocytopenia

Bertrand¹,

Martageix²,

Jallu³

et al. 2006

Journal of Thrombosis and Haemostasis

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To cite this article: Bertrand G, Martageix C, Jallu V, Vitry F, Kaplan C. Predictive value of sequential maternal anti-HPA-1a antibody concentrations for the severity of fetal alloimmune thrombocytopenia. J Thromb Haemost 2006; 4: 628-37.Summary. Background: Fetal/neonatal alloimmune thrombocytopenia results from maternal immunization against fetal platelet alloantigens (HPAs), and the major risk is intracranial hemorrhage. The severity of thrombocytopenia increases in subsequent pregnancies, and antenatal therapy has been developed. Until now, the fetal status can only be assessed by fetal blood sampling, which carries a risk of fetal loss or premature delivery. Objectives: To develop non-invasive methods to gain information on the fetal condition. Patients/ methods: Quantification of the maternal anti-HPA-1a alloantibody concentration was performed with a standardized monoclonal antibody-specific immobilization of platelet antigens (MAIPA) procedure for 43 mothers. A correlation between this concentration and the fetal/neonatal platelet counts was studied. Results: (i) Before antenatal therapy, there was a significant correlation between maternal anti-HPA-1a concentrations ‡250 AU mL )1 and fetal thrombocytopenia (2-66 · 10 9 L )1) whatever the gestational age (Fisher's exact test P ¼ 0.0021). (ii) During subsequent pregnancies, we observed a decrease of the maternal anti-HPA-1a concentration for 14/19 women. Just before delivery, all women had anti-HPA-1a concentrations <250 AU mL )1. In four cases, there was a therapy failure and the severely thrombocytopenic babies required postnatal therapy. Conclusion: The maternal anti-HPA-1a concentration could provide obstetricians with clinically useful information concerning the appropriateness and the timing of invasive monitoring procedures. However, though we observed a tendency toward a decrease in maternal antibody concentration after treatment, this finding does not allow us to draw any conclusions on the effectiveness of therapy.

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Section: Methodssupporting

confidence: 91%

Section: Discussionmentioning

confidence: 90%

Predictive value of sequential maternal anti‐HPA‐1a antibody concentrations for the severity of fetal alloimmune thrombocytopenia

Bertrand¹,

Martageix²,

Jallu³

et al. 2006

Journal of Thrombosis and Haemostasis

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“…It is tempting to assume that the higher IgGl levels in the cord blood of full term infants is a result of continued preferential transport of IgGl across the placenta in late gestation. How ever, it has been suggested that a decrease in total maternal IgG levels merely reflects maternal hemodilution, which arises form a substantial (approximately 48%) increase in maternal plasma volume that occurs during the course of gestation [12]. The increase in maternal IgGl reported here, in contrast with the falls in maternal IgG2, 3 and 4 concen trates in pregnancies at risk from HDN, casts doubt on the validity of the hemodilution hypothesis.…”

Section: Discussionmentioning

confidence: 60%

“…Samples from 50 mothers and from the cord blood of their fullterm infants were obtained with cooperation from a labour ward of a routine maternity hospital, and tested in order to assess any influence on IgG subclass concentrations attributable to the maternal haemodilution that is said to occur on delivery [12].…”

Section: Iggl Levels In Pregnancymentioning

confidence: 99%

Transplacental IgG Subclass Concentrations in Pregnancies at Risk of Haemolytic Disease of the Newborn

Lubenko¹,

Contreras²,

Rodeck³

et al. 1994

Vox Sanguinis

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The relationship of haemolytic disease of the newborn (HDN) to the transplacental passage of the four IgG subclasses was assessed at varous gestational ages by comparing the maternal and fetal IgG subclass concentrations in 34 pregnancies at risk of HDN with those in 30 pregnancies not at risk. Higher maternal and fetal IgG1 levels were attained in pregnancies at risk of HDN than in pregnancies not at risk. In contrast, a slight decrease in maternal IgG2 and IgG4 levels occurred in pregnancies at risk of HDN, as compared with a slight rise in maternal IgG2 and IgG4 levels in pregnancies not at risk of HDN. Changes in fetal IgG2 and 4 concentrations in either type of pregnancy were very similar, showing only slight increases between the 19th and 34th week of gestation. A slight decrease in maternal IgG3 occurred in both types of pregnancy. In contrast, higher and fairly steady levels of fetal IgG3 were observed in fetuses not at risk of HDN throughout gestation, when compared with those in ‘at risk’ pregnancies. However, the statistical reliability of these results is not clear since only small numbers of samples were tested and because wide variations in IgG concentrations were observed. The IgG subclass concentrations in 50 paired maternal and cord blood samples were also measured and revealed that IgGl levels were substantially higher in cord rather than maternal blood; cord and maternal IgG2, 3 and 4 levels, on the other hand, were fairly similar.

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“…However, an additional mechanism may be to reduce the titre of maternal platelet alloantibodies, possibly by a negative feedback inhibition of plasma cell antibody production. The reduction in HPA‐1a titre is greater than that anticipated due to the haemodilution of pregnancy 18 .…”

Section: Discussionmentioning

confidence: 76%

Effect of IVIgG treatment on fetal platelet count, HPA‐1a titre and clinical outcome in a case of feto‐maternal alloimmune thrombocytopenia

Lucas¹,

Hamon

Carroll

et al. 2002

BJOG

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Maternal-Fetal Immune Relationship: Another Point of View

Cited by 8 publications

References 10 publications

Predictive value of sequential maternal anti‐HPA‐1a antibody concentrations for the severity of fetal alloimmune thrombocytopenia

Predictive value of sequential maternal anti‐HPA‐1a antibody concentrations for the severity of fetal alloimmune thrombocytopenia

Transplacental IgG Subclass Concentrations in Pregnancies at Risk of Haemolytic Disease of the Newborn

Effect of IVIgG treatment on fetal platelet count, HPA‐1a titre and clinical outcome in a case of feto‐maternal alloimmune thrombocytopenia

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