Alpha-1 antitrypsin deficiency and pregnancy complications and birth outcomes: A population-based cohort study in Denmark

PLoS One. 2024 Jan 2;19(1):e0296434. doi: 10.1371/journal.pone.0296434. eCollection 2024.

Abstract

Background: Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes.

Objective: We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD.

Methods: Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children.

Results: AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50-2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14-2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05-2.40), preterm birth (RR = 1.54, 95% CI: 1.19-2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76-3.94).

Conclusions: This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history.

MeSH terms

  • Cohort Studies
  • Denmark / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications* / epidemiology
  • Premature Birth*
  • alpha 1-Antitrypsin
  • alpha 1-Antitrypsin Deficiency* / complications
  • alpha 1-Antitrypsin Deficiency* / diagnosis
  • alpha 1-Antitrypsin Deficiency* / epidemiology

Substances

  • alpha 1-Antitrypsin

Grants and funding

This study was partly funded by Alpha 1 foundation grant (https://www.alpha1.org/investigators/grants/grant-opportunities/), awarded to JH no grant number was issued. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.