Antiphospholipid antibodies increase the risk of pregnancy-induced hypertension and adverse pregnancy outcomes.
Antiphospholipid antibody (aPL) is associated with thromboembolism. There is scant evidence of a relationship between the aPL profile and serious adverse pregnancy outcome. The aim of this study was to assess whether aPL measurements during early pregnancy were useful in predicting a serious adverse pregnancy outcome. In this prospective study, we measured aPLs, including lupus anticoagulant (LA), IgG, IgM, IgA anticardiolipin antibody (aCL), IgG, IgM phosphatidylserine-dependent antiprothrombin antibody, and IgG kininogen-dependent antiphosphatidylethanolamine antibody (aPE) during the first trimester in a consecutive series of 1155 women. The 99 th percentile cut-off values in each aPL were determined using samples from 105 women who did not exhibit any pregnancy morbidity. We assessed the predictive risk of a serious adverse pregnancy outcome adjusted for confounding factors. We found that IgG aCL was associated with developing pregnancy-induced hypertension (PIH) (odds ratio 11.4, 95% CI 2.7-48); IgG aPE with PIH (8.3, 2.4-29), severe PIH (20.4, 4.5-91), and premature delivery (PD) (12.7, 3.1-50); and LA with PD (11.0, 2.8-44) and low birth weight (8.0, 2.1-31). The combinations of IgG aPE plus IgG aCL (17.5, 4.7-66.7) or IgG aPE plus LA (22.2, 5.4-909) measurements predicted severe PIH with 30.8% sensitivity and 99.2% specificity. We conclude that aPL measurements during early pregnancy may be useful in predicting adverse pregnancy outcome.
Yamada
Hideto
H
Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, Sapporo 060-8638, Japan. yhideto@med.hokudai.ac.jp
Atsumi
Tatsuya
T
Kobashi
Gen
G
Ota
Chikako
C
Kato
Emi H
EH
Tsuruga
Noriko
N
Ohta
Kaori
K
Yasuda
Shinsuke
S
Koike
Takao
T
Minakami
Hisanori
H
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood* / Q000276:immunology*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000175:diagnosis* / Q000276:immunology* / Q000503:physiopathology; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
D017152:Antibodies, Antiphospholipid