Abstract
Women with antiphospholipid antibodies are at high risk of pregnancy complications. Three hundred and two women with pregnancy complications matched with 100 women having a past history of uncomplicated pregnancy outcome were screened for the presence of antiphospholipid antibodies such as lupus anticoagulant and immunoglobulin G (IgG)/M antibodies for cardiolipin. Among the overall positivity for any one of the antiphospholipid antibodies studied, significant associations were found with recurrent pregnancy loss (OR 16.87; 95% CI, 5.5–51.63, p < 10−3), intrauterine growth retardation (OR 3.9; 95% CI, 1.08–14.05, p = 0.04) and preeclampsia (OR 4.54; 95% CI, 1.25–16.42, p = 0.035). IgG was considered a risk factor for recurrent pregnancy loss (OR 15.31; 95% CI, 3.37–69.7, p < 10−3) and intrauterine growth retardation (OR 6.7; 95% CI, 1.3–34.4, p = 0.017). The lupus anticoagulant was associated only with recurrent pregnancy loss (OR 12.4; 95% CI, 1.48–103.1, p = 0.006).
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References
Abrahams VM (2009) Mechanisms of antiphospholipid antibody-associated pregnancy complications. Thromb Res 124:521–525
Bergrem A, Jacobsen EM, Skjeldestad FE, Jacobsen AF, Skogstad M, Sandset PM (2010) The association of antiphospholipid antibodies with pregnancy-related first time venous thrombosis: a population-based case–control study. Thromb Res 125:e222–e227
Biggioggero M, Meroni PL (2010) The geoepidemiology of the antiphospholipid antibody syndrome. Autoimmun Rev 9:A299–A304
Brandt JT, Triplett DA, Alving B, Scharrer I (1995) Criteria for the diagnosis of lupus anticoagulants: an update. On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the ISTH. Thromb Haemost 74:1185–1190
Carp HJA (2004) Antiphospholipid syndrome in pregnancy. Curr Opin Obstet Gynecol 16:129–135
Cervera R, Khamashta MA, Shoenfeld Y, Camps MT, Jacobsen S, Kiss E et al (2009) Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients. Ann Rheum Dis 68:1428–1432
Damiseaux J, Peetrs L, Huperts R, Boreas A, ten Cate H, Tervaert JW (2009) Prevalence of anticardiolipin antibodies in patient cohorts with distinct clinical manifestations of the antiphospholipid syndrome. Ann NY Acad Sci 1173:146–151
Danowski A, de Azevedo MN, de Souza Papi JA, Petri M (2009) Determinants of risk for venous and arterial thrombosis in primary antiphospholipid syndrome and in antiphospholipid syndrome with systemic lupus erythematosus. J Rheumatol 36:1195–1199
Derksen RHWM, de Groot Ph (2008) The obstetric antiphospholipid syndrome. J Reprod Immunol 77:41–50
Derksen RH, De Groot PG, Nieuwenhuis HK, Christiaens GC (2001) How to treat women with antiphospholipid antibodies in pregnancy? Ann Rheum Dis 60:1–3
Duckitt K, Harrington D (2005) Risk factors for pre-eclampsia at antenatal booking: review of controlled studies. BMJ 330:565
Eyal YA, Banan M, Ariel M, Anat B, Shmuel G, Dan V et al (2004) Fetal inherited thrombophilias influence the severity of preeclampsia, IUGR and placental abruption. Eur J Obstet Gynecol Reprod Biol 113(301):31–35
Ginsberg JS, Wells PS, Brill-Edwards P, Donovan D, Moffatt K, Johnston M et al (1995) Antiphospholipid antibodies and venous thromboembolism. Blood 86:3685–3691
Girardi G, Berman J, Redecha P, Spruce L, Thurman JM, Kraus D et al (2003) Complement C5a receptors and neutrophils mediate fetal injury in the antiphospholipid syndrome. J Clin Investig 112:1639–1641
Gunasekara AP, Atherton J, McDonald N, Meulet J (2005) A unique presentation of antiphospholipid antibody syndrome in pregnancy. Heart Lung and Circulation 14:87–89
Heilmann L, von Tempelhoff G-F, Pollow K (2003) Antiphospholipid syndrome in obstetrics. Clinicaland Appl Thromb Hemost 9:143–150
Holers VM, Girardi G, Mo L, Guthridge JM, Molina H, Pierangeli SS et al (2002) Complement C3 activation is required for antiphospholipid antibodyinduced fetal loss. J Exp Med 195:211–220
Lee RM, Brown MA, Branch W, Ward K, Silver RM (2003) Anticardiolipin and anti-B2-glycoprotein I antibodies in preeclampsia. Obstet Gynecol 102:294–300
Levine JS, Branch DW, Rauch J (2002) The antiphospholipid syndrome. N Engl J Med 346:752–763
Matalon ST, Shoenfeld Y, Blank M, Yacobi S, von Landenberg P, Ornoy A (2004) Antiphosphatidylserine antibodies affect rat yolk sacs in culture: a mechanism for fetal loss in antiphospholipid syndrome. J Reprod Immunol 51:144–151
Mchrani T, Petri M (2009) Epidemiology of the antiphospholipid syndrome. Autoimmun Rev 9:A299–A304
Naess IA, Christiansen SC, Cannegieter SC, Rosendaal FR, Hammerstroem J (2006) A prospective study of anticardiolipin antibodies as a risk factor for venous thrombosis in a general population (the HUNT Study). J Thromb Haemost 4:44–49
Nodler J, Moolamalla SR, Ledge EM, Nuwayhid BS, Mulla ZD (2009) Elevated antiphospholipid antibody titers and adverse pregnancy outcomes: analysis of a population-based hospital dataset. BMC Pregnancy Childbirth 9:11
Noris M, Perico N, Remuzzi G (2005) Mechanisms of disease: pre-eclampsia. Nat Clin Pract Nephrol 1:98–114, quiz 120
Ogunyemi D, Cuellar F, Ku W, Arkel Y (2003) Association between inherited thrombophilias, antiphospholipid antibodies, and lipoprotein A levels and venous thromboembolism in pregnancy. Am J Perinatol 20:17–24
Opatrny L, David M, Kahn SR, Shrier I, Rey E (2006) Association between antiphospholipid antibodies and recurrent fetal loss in women without autoimmune disease: a metaanalysis. J Rheumatol 33:2214–2221
Ornoy A, Yacobi S, Matalon ST, Blank M, Blumenfeld Z, Miller RK et al (2003) The effects of antiphospholipid antibodies obtained from women SLE/APS and associated pregnancy loss on rat embryos and placental explants in culture. Lupus 12:573–578
Runchey SS, Folsom AR, Tsai MY, Cushman M, McGovern PD (2002) Anticardiolipin antibodies as a risk factor for venous thromboembolism in a population-based prospective study. Br J Haematol 119:1005–1010
Saha SP, Bhattcharjee N, Ganguli RP, Sil S, Patra KK, Sengupta M et al (2009) Prevalence and significance of antiphospholipid antibodies in selected at-risk obstetrics cases: a comparative prospective study. J Obstet Gynaecol 7:614–618
Sebire NJ, Backos M, El Gaddal S, Goldin RD, Regan L (2003) Placental pathology, antiphospholipid antibodies, and pregnancy outcome in recurrent miscarriage patients. Obstet Gynecol 101:258–263
Singh AK (2000) Lupus nephritis and the anti-phospholipid antibody syndrome in pregnancy. Kidney Int 58:2240–2254
Vora S, Ghosh K, Shetty S, Salvi V, Satoskar P (2007) Deep venous thrombosis in the antenatal period in a large cohort of pregnancies from western India. Thromb J 5:9
Vora S, Shetty S, Ghosh K (2008a) Thrombophilic dimension of recurrent fetal loss in Indian patients. Blood Coagul Fibrinolysis 19:581–584
Vora S, Shetty S, Salvi V, Satoskar P, Ghosh K (2008b) A comprehensive screening analysis of antiphospholipid antibodies in Indian women with fetal loss. Eur J Obstet Gynecol Reprod Biol 137:136–140
Yaniv S, Miri B, Yehuda S (2007) Antiphospholipid syndrome (APS): does it come from? Pract Res Clin Rheumatol 21:1071–1078
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Klai, S., Fekih-Mrissa, N., Mrissa, R. et al. The signification of antiphospholipid antibodies in pregnancy-associated pathologies and venous thromboembolism. Comp Clin Pathol 21, 461–465 (2012). https://doi.org/10.1007/s00580-010-1119-x
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DOI: https://doi.org/10.1007/s00580-010-1119-x