title: 14th International Congress on Antiphospholipid Antibodies Task Force report on obstetric antiphospholipid syndrome.
abstract: Pregnancy morbidity is one of the clinical manifestations used for classification criteria of antiphospholipid syndrome (APS). During the 14th International Congress on Antiphospholipid Antibodies (aPL), a Task Force with internationally-known experts was created to carry out a critical appraisal of the literature available regarding the association of aPL with obstetric manifestations present in actual classification criteria (recurrent early miscarriage, fetal death, preeclampsia and placental insufficiency) and the quality of the evidence that treatment(s) provide benefit in terms of avoiding recurrent adverse obstetric outcomes. The association of infertility with aPL and the effectiveness of the treatment of patients with infertility and positive aPL was also investigated. This report presents current knowledge and limitations of published studies regarding pregnancy morbidity, infertility and aPL, identifying areas that need better investigative efforts and proposing how critical flaws could be avoided in future studies, as suggested by participants of the Task Force. Except for fetal death, there are limitations in the quality of the data supporting the association of aPL with obstetric complications included in the current APS classification criteria. Recommended treatments for all pregnancy morbidity associated to APS also lack well-designed studies to confirm its efficacy. APL does not seem to be associated with infertility and treatment does not improve the outcomes in infertile patients with aPL. In another section of the Task Force, Dr. Jane Salmon reviewed complement-mediated inflammation in reproductive failure in APS, considering new therapeutic targets to obstetric APS (Ob APS).
authors.affiliation: Department of Obstetrics, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: guilhermedejesus@gmail.com.
authors.forename: Guilherme R
authors.initials: GR
authors.lastname: de Jesus
authors.affiliation: The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Nancy
authors.initials: N
authors.lastname: Agmon-Levin
authors.affiliation: Instituto de Pesquisa Clinica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Andrade
authors.affiliation: Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, Spedali Civili, University of Brescia, Brescia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Andreoli
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Immunorheumatological Research Laboratory, Istituto Auxologico Italiano, Milan, Italy.
authors.forename: Cecilia B
authors.initials: CB
authors.lastname: Chighizola
authors.affiliation: Department of Obstetrics and Gynecology, University of UT, Salt Lake City, USA; Intermountain Healthcare, Salt Lake City, USA.
authors.forename: T Flint
authors.initials: TF
authors.lastname: Porter
authors.affiliation: Hospital For Special Surgery, Weill Cornell Medical College, NY, USA; Kirkland Center for Lupus Research, NY, USA; Lupus and APS Center of Excellence, NY, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Salmon
authors.affiliation: Department of Obstetrics and Gynecology, University of UT, Salt Lake City, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.affiliation: Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, Spedali Civili, University of Brescia, Brescia, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
authors.affiliation: Department of Obstetrics and Gynecology, University of UT, Salt Lake City, USA; Intermountain Healthcare, Salt Lake City, USA.
authors.forename: D Ware
authors.initials: DW
authors.lastname: Branch
mesh_terms: D026683:Advisory Committees; D000818:Animals; D017152:Antibodies, Antiphospholipid / Q000276:immunology* / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D003226:Congresses as Topic; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Antiphospholipid syndrome; Complement; Fetal death; Infertility; Preeclampsia; Recurrent early miscarriage