4.7 Article

Persistent antiphospholipid antibodies do not contribute to adverse pregnancy outcomes

Journal

RHEUMATOLOGY
Volume 52, Issue 9, Pages 1642-1647

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/ket173

Keywords

anti-phospholipid antibodies; antiphospholipid syndrome; pregnancy outcomes; placental insufficiency; pre-eclampsia; small for gestational age; adverse outcomes; intrauterine death; fetal growth; pregnancy loss

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Funding

  1. Rose Hellaby Medical Scholarship Trust from New Zealand
  2. National Institute of Health Research (NIHR), United Kingdom
  3. National Institute for Health Research [CL-2010-17-007] Funding Source: researchfish

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Methods. This was a case-control study between 2005 and 2011 where we identified 73 women with persistent aPL and coincidentally the same number with obstetric APS. Unmatched controls were identified from low-risk clinics (ratio 1:4). Women with multiple pregnancies, fetal anomalies, SLE, thrombotic APS and other thrombophilias were excluded. Results. Cases and controls were demographically similar, with the exception of younger controls with fewer medical comorbidities. aPL profiles were similar between aPL and APS. In women with aPL, risk of APS-type complications (odds ratio 1.3; 95% CI 0.6, 2.9) and birthweight distribution (median birthweight on a customized centile was 50.8, interquartile range 26.4-68.9; P < 0.05) were similar to controls. These findings persisted even after adjustment for maternal age and medical comorbidities. Conclusion. Women with persistent aPL on aspirin had pregnancy outcomes that were similar to controls. These data suggest that in the absence of other risk factors, women with aPL do not need intense antenatal surveillance or modified management in pregnancy.

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