title: Prednisone does not prevent recurrent fetal death in women with antiphospholipid antibody.
abstract: Effects of therapy, antibody titer, and pregnancy history on pregnancy outcome were evaluated in pregnancies of women with antiphospholipid antibody. Prior fetal death and a high antiphospholipid antibody titer (greater than 40 IgG phospholipid units) contributed independently, in an additive manner, to current fetal loss. Twenty-one pregnancies occurred in asymptomatic women who had both prior fetal death and a high IgG antiphospholipid antibody titer. In this very high-risk group, 9 of 11 (82%) of pregnancies treated with prednisone, 10 to 60 mg/day, ended in fetal death, compared with 5 of 10 (50%) not treated with prednisone (p approximately 0.01, life-table analysis). Of pregnancies treated with aspirin, 80 mg/day, 9 of 14 (64%) treated and 5 of 7 (71%) not treated with prednisone had a fetal death (difference not significant). Prednisone does not improve, and may worsen, current fetal outcome in asymptomatic pregnant women with a high antiphospholipid antibody titer and prior fetal death.
authors.affiliation: Division of Rheumatic Diseases, Hospital for Special Surgery-Cornell University Medical College, New York, NY 10021.
authors.forename: M D
authors.initials: MD
authors.lastname: Lockshin
authors.forename: M L
authors.initials: ML
authors.lastname: Druzin
authors.forename: T
authors.initials: T
authors.lastname: Qamar
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D001323:Autoantibodies / Q000032:analysis*; D005260:Female; D005313:Fetal Death / Q000517:prevention & control*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000276:immunology; D010743:Phospholipids / Q000276:immunology*; D011241:Prednisone / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000276:immunology; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D001323:Autoantibodies; D010743:Phospholipids; D001241:Aspirin; D011241:Prednisone