title: Antiphospholipid antibodies increase the risk of pregnancy-induced hypertension and adverse pregnancy outcomes.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, Sapporo 060-8638, Japan. yhideto@med.hokudai.ac.jp
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Atsumi
authors.forename: Gen
authors.initials: G
authors.lastname: Kobashi
authors.forename: Chikako
authors.initials: C
authors.lastname: Ota
authors.forename: Emi H
authors.initials: EH
authors.lastname: Kato
authors.forename: Noriko
authors.initials: N
authors.lastname: Tsuruga
authors.forename: Kaori
authors.initials: K
authors.lastname: Ohta
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yasuda
authors.forename: Takao
authors.initials: T
authors.lastname: Koike
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: 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
chemical_list: D017152:Antibodies, Antiphospholipid