When reviewing laboratory results for a 1-day-old infant, the nurse notes that the infant's IgM antibodies are elevated. Which is the least likely cause of the infant's IgM antibody level elevation?
1. Maternal-fetal transfer of IgM while in utero
2. Placental leakage
3. Intrauterine exposure to syphilis
4. Intrauterine exposure to TORCH syndrome
Correct Answer: 1
Rationale 1: Because IgM does not normally cross the placenta, most or all of it is produced by the fetus beginning at 10 to 15 weeks' gestation. Elevated levels of IgM at birth may indicate placental leaks or, more commonly, antigenic stimulation in utero.
Rationale 2: Elevated levels of IgM at birth may indicate placental leaks.
Rationale 3: Elevations in IgM may be due to newborn exposure to an intrauterine infection such as syphilis.
Rationale 4: Elevations in IgM at birth may be due to newborn exposure to an intrauterine infection such as syphilis or TORCH syndrome (toxoplasmosis, rubella, cytomegalovirus, herpesvirus hominis type 2 infection).
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