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  • P145 Circulating interferon-α levels are elevated during pregnancy in women with SLE who deliver infants that are small for gestational age, preterm and/or have low birth weight

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P145 Circulating interferon-α levels are elevated during pregnancy in women with SLE who deliver infants that are small for gestational age, preterm and/or have low birth weight
  1. Marit Stockfelt1,2,
  2. Agnes Torell1,
  3. Kaj Blennow3,
  4. Henrik Zetterberg3,4,5,6,7,8,
  5. Tansim Akhter9,
  6. Dag Leonard10,
  7. Lars Rönnblom10,
  8. Sofia Pihl11,12,
  9. Muna Saleh13,
  10. Christopher Sjöwall13,
  11. Helena Strevens14,
  12. Andreas Jönsen15,
  13. Anders A Bengtsson15,
  14. Estelle Trysberg2,
  15. Maria Majcuk Sennström16,
  16. Agneta Zickert17,
  17. Elisabet Svenungsson17,
  18. Iva Gunnarsson17,
  19. Bo Jacobsson18,19,20,
  20. Anna-Carin Lundell1 and
  21. Anna Rudin1
  1. 1Dept. of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sweden
  2. 2Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
  3. 3Dept. of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
  4. 4Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
  5. 5Dept. of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
  6. 6UK Dementia Research Institute at UCL, London, UK
  7. 7Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
  8. 8Winsconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
  9. 9Dept. of Women’s and Children’s Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
  10. 10Dept. of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden
  11. 11Dept. of Obstetrics and Gynecology, Linköping University Hospital
  12. 12Dept. of Biomedical and Clinical Sciences, Division of Children’s and Women’s Health, Linköping University, Linköping, Sweden
  13. 13Division of Inflammation and Infection, Dept. of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
  14. 14Dept. of Obstetrics and Gynecology, Institute of Clinical Sciences, Skåne University Hospital, Lund, Sweden
  15. 15Dept. of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden
  16. 16Dept. of Womens and Childrens Health, Division for Obstetrics and Gynecology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
  17. 17Dept. of Medicine Solna, Division of Rheumatology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
  18. 18Dept. of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg Sweden
  19. 19Dept. of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg Sweden
  20. 20Dept. of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway

Abstract

Objectives Adverse pregnancy outcomes (APOs) are more common among women with SLE compared to the general population and the underlying immunopathological mechanisms are largely unknown. The type I interferon (IFN) signature persists in complicated SLE pregnancies, while it is downregulated in uncomplicated SLE pregnancies. Moreover, IFNα protein concentrations are higher in SLE compared to healthy pregnancies, but whether IFNα protein levels are associated with APOs in SLE is unknown. The aim of this study was to evaluate whether APOs are more common in Swedish women with SLE compared to healthy controls, and if this associates with circulating IFNα protein or autoantibodies.

Methods We included 83 births from 77 women with SLE and 58 births from 58 healthy controls (HC). Repeated peripheral blood samples were collected and IFNα protein levels were quantified with Simoa. Anti-nuclear antibody (ANA) specificities and anti-phospholipid antibodies (aPL) during pregnancy was analysed using multiplexed bead technology. APOs were defined as an infant small for gestational age (SGA), preterm birth, low birth weight (LBW) and/or preeclampsia. Multivariate orthogonal partial least squares analysis (OPLS) was used to examine SGA, LBW and/or preterm (combined outcomes, Y-variable) in relation to mean IFNα protein level, IFNα positivity, ANA specificity and aPL positivity during pregnancy.

Results APOs were more common in women with SLE compared to healthy women (33% compared to 12%, p=0.005). The most common outcome was SGA, which was present in 17% of women with SLE compared to 3% of HC (p=0.01). In OPLS, SGA, LWB and/or preterm birth was most positively associated to mean IFNα protein level and IFNα positivity in plasma during pregnancy. Preeclampsia was unrelated to IFNα and autoantibody positivity in women with SLE. In univariate analysis, the mean IFNα protein level was significantly higher in women with SLE who had an infant who was SGA, LBW and/or preterm compared to women without these APOs.

Conclusion IFNα protein level in plasma is a potential risk factor for giving birth to an infant who is small for gestational age, has low birth weight and/or is delivered preterm in SLE.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.199

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