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J Clin Immunol (2014) 34:853863 DOI 10.1007/s10875-014-0069-5
ORIGINAL RESEARCH
IgA Deficiency, Autoimmunity & Pregnancy: A Population-Based Matched Cohort Study
Jonas F Ludvigsson & Martin Neovius &
Olof Stephansson & Lennart Hammarstrm
Received: 1 March 2014 /Accepted: 6 June 2014 /Published online: 9 July 2014 # Springer Science+Business Media New York 2014
AbstractBackground Several autoimmune disorders have been linked to adverse pregnancy outcome. IgA deficiency shares many autoimmune traits, but its association with pregnancy outcome is unknown.
Methods Prospective population-based cohort study in Sweden of 613 mothers with IgA deficiency (IgA levels<.07 g/L) diagnosed in 19802010 in six university hospitals. In 1973 2010, these women delivered 1,172 singleton infants registered in the Swedish Medical Birth Register. Each delivery to a woman with IgA deficiency was matched on maternal age, parity, early pregnancy smoking status, education level, and delivery year with up to 5 control births (n=5,758).
Results Offspring to women with IgA deficiency had 79 g lower birth weight than controls (meanSD: 3,457559 vs 3,537553 g, P<0.001), and 1.4 days shorter gestational age
(meanSD: 27813 vs 28014 days, P=0.001). No difference in preterm birth (<37 weeks) could be detected in deliveries to women with IgA deficiency vs control deliveries(5.8 % vs 5.2 %; odds ratio (OR)=1.13, 95%CI=0.851.49), but small for gestational age birth was more common(4.3 % vs 2.8 %; OR=1.48, 95%CI=1.042.10). Women with IgA deficiency also delivered more often by caesarean section(16.9 % vs 11.9 %; OR=1.51, 95%CI=1.261.82), while no difference was observed regarding low Apgar score (<7 at 5 min; 1.1 % vs 1.0 %; OR=1.18; 95%CI=0.622.27). When excluding women with autoimmune diseases, the excess risks of adverse pregnancy outcome diminished.
Conclusion There is a small excess risk of certain adverse delivery and perinatal outcomes among offspring to women with IgA deficiency. These excess risks are attenuated when considering the presence of autoimmune diseases.
Keywords Autoimmune . childbirth . IgA deficiency . immunoglobulin . pregnancy . perinatal outcomes
Introduction
Selective IgA deficiency is an immunodeficiency that is characterized by total IgA levels <0.07 g/L,[1] which occurs in about 1:200600 Caucasians. IgA is instrumental for the mucosal immune defense, and has been linked to recurrent respiratory and gastrointestinal infections [24]. In addition to an excess risk of infections, individuals with IgA deficiency seem to be...