Summary
Pregnancy and delivery have measurable effects on haemostatic and immunological changes.
Degradation of fibrinogen induces significant structural and conformational modulation
and leads to the progressive loss of antigenic sites present on the parent molecule
but also exposes some new sites. These neoantigens may be recognized by the immune
system and may be elicited by the autologous host manifested by the production of
autoantibodies. Therefore in the present study, in pregnant and post delivery women
and in the newborns, levels of antibodies against fibrinogen, fibrin(ogen) degradation
products (FDP) and fibrin degradation products (D-dimer) were examined.
Enzyme immunoassay (ELISA) was used to detect and quantitate autoantibodies against
fibrinogen (class G immunoglobulin) in human sera. In all sera there were found varying
concentrations of autoantibodies and their levels were significantly higher in all
pregnant women in comparison with non-pregnant ones. Significantly higher levels were
found in Rh immunized and clinically complicated pregnancies.
The level of autoantibodies, coagulation and fibrinolytic system components were higher
in post delivery women than in normal pregnant women. Also antibodies to fibrinogen
were studied in cord serum of newborns in different terms of delivery. The low levels
of antibodies in all newborns raise questions of possible foetal-maternal immunologic
interactions. Positive correlation between mothers and newborns was demonstrated after
delivery at gestational age from 34th to 41st week, and negative in 42nd and more
week. There were no significant differences in antibody level among the newborns delivered
by the same mothers.
It was found that autoantibodies bind selectively to the fibrinogen and fibrinogen
fragments X, Y and D. These autoantibodies may represent a new interface between the
coagulation and the immune systems which may be significant in controlling the pathologic
activities of the cleavage fragments.