APA (Antiphospholipid antibodies) relate to blood-clotting disorders in pregnancy. These are a major cause of problems in pregnancy because all women’s blood gets thicker during pregnancy anyway, but the extent to which it thickens both varies between women, and it can also vary between pregnancies. If the blood becomes too thick it alters the bonds between the cells which increase the chances of clots forming, and this can trigger serious problems for a pregnancy, because if the clots form in the blood vessels of the placenta they’ll restrict the flow of blood carrying nutrients and oxygen to the baby, and they’ll also increase the chances of more clots forming.
The immune system has a crucial role in regulating the chances of blood clotting, and with the thicker blood that naturally comes with pregnancy, the immune system needs to adapt and suppress the chances of blood clots forming to make sure blood flows freely to the baby. There’s a condition called ‘thrombophilia’ (a liking to clot) where blood clotting isn’t suppressed, and although this condition affects both sexes, as far as parenting is concerned it’s only an issue when mothers are affected. Thrombophilia increases the risks of a range complications in pregnancy:
- Implantation failure
- Pre-term delivery
- Severe pre-eclampsia
- The birth of a baby with low birth weight
Thrombophilia is a major cause for all these conditions, and is found in about 60% of women who have an unexplained pregnancy loss.
Phospholipids are molecules that make up the cell walls of all forms of life and they allow particles to enter and exit cells and determine how cells ‘behave’ in a physical way with those around them; this means they’re able to make cells more ‘sticky’ (important for fertilization and implantation) or not sticky:
- If they repel other cells it means that essential attachment functions are lost
- If they’re too sticky then cells stick too easily and they’ll clump together
When the phospholipid part of the immune system isn’t in balance it affects how a cell’s membranes relate to other cells around them; for example one of the phospholipid antibodies (anti-ethanolamine antibodies) can stop a sperm’s ability to bind to an egg, and if it’s identified ICSI instantly becomes the preferred treatment for the couple involved. Antiphospholipid antibodies can also make blood clot too fast,