Outcomes of pregnancies in women with suspected antiphospholipid syndrome.
OBJECTIVE
To evaluate maternal and neonatal outcomes in women suspected to have primary antiphospholipid syndrome (PAPS).


METHODS
A cohort from the Nova Scotia Atlee Perinatal Database (n = 211034) was studied. A total of 58 women with antiphospholipid antibodies without a clinical diagnosis of rheumatologic disease were evaluated. We compared them to maternal and neonatal outcomes of women without rheumatologic disease or PAPS who delivered in Nova Scotia 1988-2008.


RESULTS
With PAPS, mean maternal age was older; mean gestational age and mean neonatal birth weight were less. With bivariate analysis, maternal colonization and urinary tract infection with group B streptococcus, thromboembolic disease, thrombocytopenia and Caesarean birth were more frequent in the suspected PAPS group compared to the control. Among neonates, hyperbilirubinemia, anemia, apnea, intraventricular hemorrhage grade I and II, retinopathy of prematurity, bronchopulmonary dysplasia, neonatal intensive care unit admission, and assisted ventilation occurred more frequently with PAPS. Babies in PAPS group had a longer hospital stay (8.7 vs 3.9 days). Logistic regression analysis identified that PAPS was only associated with increased risks of preeclampsia (Odds Ratio (OR) 2.2; 95% Confidence Interval (CI) 1.1-4.3; P = 0.016), urinary tract infection (OR 2.2; 95% CI 1.1-4.6; P = 0.02), and prematurity (gestational age ≤37) (OR 2.2; 95% CI, 1.07-4.3, P = 0.03). Positive predictive values for pregnancy induced hypertension, urinary tract infection and prematurity in women who had suspected APS were 24.1%, 17.2% and 45.6% respectively.


CONCLUSIONS
With suspected PAPS, risks for preeclampsia, urinary tract infection and prematurity are increased. Outcomes for babies are related to prematurity.
Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.
F
F
Nili
L
L
McLeod
C
C
O'Connell
E
E
Sutton
D
D
McMillan
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009674:Nova Scotia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012307:Risk Factors; D055815:Young Adult
Antiphospholipid antibodies; antiphospholipid syndrome; newborn; outcome; pregnancy