Antinuclear Antibodies (ANA)

Antinuclear antibody (ANA) testing is used for evaluating autoimmune activity during pregnancy, as elevated ANA levels may increase the risk of complications. This article covers the role of ANA testing in pregnancy, reference ranges, and common causes of positive results to help guide clinical care and improve outcomes for both mother and baby.

ANA Testing

Assess for the presence of antinuclear antibodies (ANA) via the ANA by IFA, Reflex to Titer and Pattern. 

Antinuclear antibodies are a group of antibodies that attack the nucleus of cells. They can attack various components of the nucleus, including DNA, histones, nucleolar proteins, and nuclear antigens. The specific pattern in staining can provide insight into the type of attack. They are most associated with systemic lupus erythematosus but can also be found in other autoimmune conditions.

ANA testing is reported as a titer (concentration). ANA titers are represented as a dilution factor in ratio to the highest dilution at which ANAs are still detectable. For example, 1:40 means the patient’s serum was diluted 40 times before ANAs were still detected. The higher the titer, the more autoantibodies are present.

ANA in Pregnancy

ANA antibodies should not be present in pregnancy. They can affect placental development and lead to early pregnancy loss. ANA antibodies have been shown to be higher in pregnancy, even in normal pregnancies. 

High ANA in Pregnancy

ANA antibodies are not uncommon in women with unexplained recurrent miscarriages, suggesting a role for autoimmune disease in cases of unexplained pregnancy loss.

Titers of >1:160 are highly associated with unexplained recurrent pregnancy loss, while titers of <1:80 are not.

Some studies have found that antinuclear antibodies occur more often in patients with preeclampsia, intrauterine growth retardation, fetal death, and placental abruption. Other studies, however, have not confirmed these results; therefore, there is not a clear connection.

Most Common Causes of High ANA in Pregnancy

• Certain Medications (Hydralazine, Procainamide, Minocycline, Sulfa drugs, Penicillin, Methyldopa, Quinidine, and Chlorpromazine)
• Latent Viral Infections
• Parasites
• Environmental Toxin Exposure 
• Heavy Metal Exposure
• Glyphosate Exposure
• UV Skin Damage
• Celiac Disease (Untreated)
• Nutritional Deficiencies (vitamin D, vitamin C)
• Stress
• Genetics

Low ANA in Pregnancy

​Low titers are not associated with pregnancy complications.

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Medical Disclaimer:
This content is for educational purposes only and is intended for licensed medical professionals. It is based on current research, subject to change, and not intended to diagnose, treat, or prevent any medical condition. This information does not replace consultation with a qualified healthcare provider. Seek professional medical evaluation and treatment from a licensed provider. Use of this information is at your own risk.​

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