{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:05:26Z","timestamp":1792785926010,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MEXT Promotion of Distinctive Joint Research Center Program","award":["JPMXP0621467963"],"award-info":[{"award-number":["JPMXP0621467963"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>STUDY QUESTION<\/jats:title>\n                    <jats:p>Can antinuclear antibodies (ANA) affect the subsequent live birth rate (LBR) in patients with unexplained recurrent pregnancy loss (RPL) in the absence of antiphospholipid antibodies (aPL)?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SUMMARY ANSWER<\/jats:title>\n                    <jats:p>Women with unexplained RPL have a high probability of live birth following a positive pregnancy test (&amp;gt;70%), being similar between those with positive and negative ANA testing, regardless of the cut-off value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                    <jats:p>The RPL guidelines of the ESHRE state that \u2018ANA testing can be considered for explanatory purposes\u2019. However, there have been a limited number of studies on this issue and sample sizes have been small, and the impact of ANA on the pregnancy prognosis is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at Nagoya City University Hospital between 2006 and 2019. The study included 1021 women with RPL without known cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                    <jats:p>Hysterosalpingography or 3D-ultrasound, chromosome analysis for both partners, blood tests for aPL, ANA, hypothyroidism, and diabetes mellitus were performed before a subsequent pregnancy. ANAs were measured by indirect immunofluorescence on Hep-2 cell slides. The cutoff dilution used was 1:40. In addition, patients were classified according to the ANA pattern on immunofluorescence staining: homogeneous, speckled, nucleolar, centromeric, peripheral, cytoplasmic, and others. LBRs were compared between ANA-positive and ANA-negative patients after excluding patients with antiphospholipid antibody syndrome, an abnormal chromosome in either partner and a uterine anomaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                    <jats:p>Considering the cut-off value = 1:40 dilution, the subsequent LBRs were 72.5% (256\/353) for the ANA-positive group and 73.2% (489\/668) for the ANA-negative group; odds ratio (OR) = 0.97, 95% CI = 0.72\u20131.29. After excluding the miscarriages occurring from embryonic aneuploidy, the biochemical pregnancy losses, and the ectopic pregnancies, LBRs were 92.8% (256\/276) for the ANA-positive group and 93.0% (489\/526) for the ANA-negative group: OR = 0.97 (95% CI = 0.55\u20131.70). Considering the cut-off value = 1:80 dilution, the subsequent LBRs were 75.0% (87\/116) for the ANA-positive group and 72.7% (658\/905) for the ANA-negative group; OR = 1.13 (95% CI = 0.72\u20131.76). After excluding the miscarriages occurring from embryonic aneuploidy, the biochemical pregnancy losses, and the ectopic pregnancies, LBRs were 89.7% (87\/97) for the ANA-positive group and 93.3% (658\/705) for the ANA-negative group: OR = 0.62 (95% CI = 0.30\u20131.27). Considering the cut-off value = 1:160 dilution, the subsequent LBRs were 82.4% (28\/34) for the ANA-positive group and 72.6% (717\/987) for the ANA-negative group; OR = 1.76 (95% CI = 0.72\u20134.29). After excluding the miscarriages occurring from embryonic aneuploidy, the biochemical pregnancy losses, and the ectopic pregnancies, LBR were 93.3% (28\/30) for the ANA-positive group and 92.9% (717\/772) for the ANA-negative group: OR = 1.07 (95% CI = 0.25\u20134.63). There was no difference in LBR between the 2 groups before or after adjustment for age and BMI, but ANA-positive patients were significantly older than ANA-negative patients when using the 1:40 dilution, and ANA-positive patients had significantly lower BMIs than ANA-negative patients when using the 1:80 dilution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                    <jats:p>A healthy control group was not established, making it impossible to compare ANA positivity rates between healthy controls and RPL patients. There were significant differences in age (1:40 dilution) and BMI (1:160 dilution) between the ANA-positive and ANA-negative groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                    <jats:p>Our results suggest that ANA testing is not useful to predict future pregnancy loss in women with RPL without known cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n                    <jats:p>This study was supported by MEXT Promotion of Distinctive Joint Research Center Program, Grant Number JPMXP0621467963 and used for English proofreading costs. There are no competing interests for all authors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION NUMBER<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humrep\/deae280","type":"journal-article","created":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T07:20:58Z","timestamp":1733642458000},"page":"236-243","source":"Crossref","is-referenced-by-count":13,"title":["Association between antinuclear antibodies and pregnancy prognosis in recurrent pregnancy loss patients"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9306-2849","authenticated-orcid":false,"given":"H","family":"Yoshihara","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Nagoya City University , Nagoya, 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