title: Antiphospholipid antibodies and preeclampsia: a case-control study.
abstract: OBJECTIVE
  To assess the association between the occurrence first of preeclampsia and antiphospholipid antibodies.
  
  
  METHODS
  We conducted a prospective case-control study of 180 pregnant women with their first incidents of preeclampsia and no histories of thrombosis or systemic autoimmune diseases. Preeclampsia (n = 180) was defined as blood pressure (BP) at least 140/90 mmHg after 20 weeks' gestation and proteinuria at least 0.3 g per 24 hours. Two control subjects were matched to each case (n = 360). They were pregnant women without hypertension or proteinuria and without histories of thrombosis or systemic autoimmune disease. Lupus anticoagulant (activated partial thromboplastin time, diluted thromboplastin time, platelet neutralization procedure) and anticardiolipin antibodies (immunoenzymatic assays) were assessed in both groups, and the coagulation state (levels of thrombin-antithrombin III complexes, fragments 1 + 2 of prothrombin) was also evaluated. The analysis design was a sequential plan with 5% type I error and 95% power.
  
  
  RESULTS
  There was no association between antiphospholipid antibodies and preeclampsia. The odds ratio for the association was 0.95 (95% confidence interval 0.45, 2.61). Antiphospholipid antibodies were detected in eight of 180 preeclamptic women and in 19 of 360 controls. In contrast, there was a clear, confirmed activation of coagulation during preeclampsia.
  
  
  CONCLUSIONS
  Despite evidence of a prothrombotic state during preeclampsia, it is unlikely that antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) represent risk factors for preeclampsia among women with no previous preeclampsia and no histories of thrombosis or systemic autoimmune disease.
authors.affiliation: Department of Obstetrics and Gynecology I, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. dreyfus-m@chu-caen.fr
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
authors.forename: G
authors.initials: G
authors.lastname: Hedelin
authors.forename: R
authors.initials: R
authors.lastname: Kutnahorsky
authors.forename: M
authors.initials: M
authors.lastname: Lehmann
authors.forename: B
authors.initials: B
authors.lastname: Viville
authors.forename: B
authors.initials: B
authors.lastname: Langer
authors.forename: A
authors.initials: A
authors.lastname: Fleury
authors.forename: M
authors.initials: M
authors.lastname: M'Barek
authors.forename: A
authors.initials: A
authors.lastname: Treisser
authors.forename: M L
authors.initials: ML
authors.lastname: Wiesel
authors.forename: J L
authors.initials: JL
authors.lastname: Pasquali
mesh_terms: D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000032:analysis*; D011225:Pre-Eclampsia / Q000097:blood* / Q000276:immunology; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D017153:Antibodies, Anticardiolipin; D016682:Lupus Coagulation Inhibitor