title: Association of anticardiolipin antibodies with preeclampsia: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically review the evidence of the association of anticardiolipin antibodies with preeclampsia.
  
  
  METHODS
  PubMed and LILACS were perused up to June 2009, citations were searched using the ISI Web of Knowledge database, textbooks and reference lists were reviewed, and experts were contacted. Search terms included "antiphospholipid syndrome," "Hughes' syndrome," "anticardiolipin antibodies," "antiphospholipid antibodies," "anti-cardiolipin," "preeclampsia," and "pre-eclampsia."
  
  
  METHODS
  Inclusion criteria were: cohorts, case-control, or controlled cross-sectional studies; healthy pregnancy as controls; no autoimmune diseases; immunoglobulin (Ig)G, IgM anticardiolipin antibody of at least 20 units by enzyme-linked immunosorbent assay, or both; and end-point preeclampsia.
  
  
  RESULTS
  Our search generated 68,528 entries and 64 full-text articles were reviewed. Twelve studies were included in the meta-analysis. Pooled odds ratio (OR) for association of anticardiolipin antibodies with preeclampsia was 2.86 (95% confidence interval [CI], 1.37-5.98). Pooled OR for anticardiolipin antibodies and severe preeclampsia was 11.15 (95% CI 2.66-46.75). Funnel plot showed minor asymmetry, and the Egger test was not significant (P=.359). Meta-regression identified study design and size as related to heterogeneity.
  
  
  CONCLUSIONS
  Moderate-to-high levels of anticardiolipin antibodies are associated with preeclampsia, but there is insufficient evidence to use anticardiolipin antibodies as predictors of preeclampsia in clinical practice.
authors.affiliation: From the Rheumatology Department, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Post Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Aline D
authors.initials: AD
authors.lastname: do Prado
authors.forename: Deise M
authors.initials: DM
authors.lastname: Piovesan
authors.forename: Henrique L
authors.initials: HL
authors.lastname: Staub
authors.forename: Bernardo L
authors.initials: BL
authors.lastname: Horta
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000209:etiology / Q000276:immunology*; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D017153:Antibodies, Anticardiolipin