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Patients with APS, triple aPL positivity at higher risk for adverse pregnancy outcomes
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Patients with antiphospholipid syndrome who had triple antiphospholipid antibody positivity were more likely to experience an adverse outcome in pregnancy, according to data presented recently.
Researchers retrospectively reviewed 217 pregnancies in 154 women treated by a team of obstetricians and rheumatologists between 1985 and 2014. Included patients had primary antiphospholipid syndrome (APS), non-criteria APS or were carriers of antiphospholipid antibody (aPL), and patients with additional autoimmune diseases were excluded. Patients were stratified according to single, double or triple aPL positivity.
Adverse pregnancy outcomes (APOs) were defined as miscarriage prior to the 10th week, fetal death after 10 weeks, severe preterm delivery prior to the 34th week with or without pre-eclampsia, HELLP syndrome or perinatal death.
An APO occurred in 33 pregnancies (15%), 14 of which occurred in triple-positive mothers (42%), 14 occurred in mothers with single positivity (42%) and five occurred in mothers with double positivity (15%). Fifteen APOs (45%) occurred in mothers without anti-La antibodies. Only 19% of triple-positive patients with APS had favorable pregnancy outcomes compared with 28% in double-positive women and 53% of single-positive patients. No differences were seen between low vs. high titers of antibodies, except that compared with low titers, medium-high titers of immunoglobulin G aB2GPI were associated with APOs in 17 pregnancies. All women were triple-positive, according to the researchers. – by Shirley Pulawski
Reference:
Lazzaroni MG, et al. Paper #FRI0409. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.