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IVIg therapy increases delivery birthweight in babies born to women with elevated preconception proportion of peripheral blood (CD56+/CD3-) natural killer cells
1 Laboratory for Reproductive Medicine and Immunology, San Jose, CA, USA
Clin. Exp. Obstet. Gynecol. 2017, 44(3), 384–391; https://doi.org/10.12891/ceog3721.2017
Published: 10 June 2017
Summary: In this study, the authors investigated: (1) whether elevated preconception peripheral blood proportion of CD56+ /CD3- lymphocytes (NK cells) was associated with low delivery birthweight in high risk women, and (2) whether intravenous immunoglobulin (IVIg) therapy could be used to improve the delivery outcome in these women. Materials and Methods: Sixty-six women who had singleton deliveries were divided into four groups. Group 1: 16 women with elevated preconception NK cells (>12%) using IVIg, group 2: eight women with similar elevated preconception NK cells not using IVIg, group 3: 32 women with non-elevated preconception NK cells (≤ 12%) using IVIg, and group IV: ten women with similar non-elevated preconception NK cells not using IVIg. These groups were similar with regards to patient age, test results, and history. Results: Mean gestational age (±SD) of babies at delivery was 39.3 ± 1.7, 37.4 ± 3.7, 38.5 ± 1.3, and 38.7 ± 1.5 weeks, for groups 1, 2, 3 and 4, respectively. Mean birthweight of babies at delivery was 3,267 ± 373, 2,654 ± 627, 3,129 ± 527, and 3,202 ± 357 grams, respectively. Birthweight was significantly higher for group 1 vs. group 2 (p = 0.006) but not for groups 1 vs. group 3. There was no significant difference between the groups for preeclampsia rate, C-section rate or preterm delivery rate. Conclusion: In women with elevated preconception peripheral NK cells, mean birthweight at delivery is low without IVIg therapy (2,654 ± 627 grams) but significantly improved with IVIg therapy (3,267 ± 373 grams). In high risk women without preconception NK cell elevation, mean birthweight at delivery is not further increased with IVIg therapy (3,202 ± 357 grams with IVIg vs. 3,129 ± 527 grams without IVIg). IVIg may be a treatment option for women with preconception NK elevation at risk of a low birthweight baby. Preconception immune testing may be a tool for determining which patients will benefit from IVIg therapy. Larger repeat studies are needed for confirmation.
Natural killer cell