Pregnancy and Clinical Outcome Among Women with Antiphospholipid Antibody Syndrome—A Tertiary Care Center–Based Observational Study

SN Comprehensive Clinical Medicine Pub Date : 2024-01-19 DOI:10.1007/s42399-024-01643-z

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Abstract

Antiphospholipid antibody syndrome (APS) is an acquired thrombophilia with multisystem involvement. This study was undertaken to study the antibody profile of pregnant women with APS and their pregnancy outcomes. This retrospective study was conducted in a tertiary care teaching institute in Southern India. Data of 231 APS-positive pregnancies in 104 women were analyzed in this study. The primary outcome was to study the adverse outcomes such as abortions, intrauterine fetal death, neonatal death, maternal thrombotic events, and preeclampsia in APS-complicated pregnancies. Secondary outcomes were to study the adverse clinical outcomes in comparison to various antiphospholipid antibodies; primary versus secondary APS; and obstetric versus thrombotic APS. Anticardiolipin antibody (ACLA) (n = 157, 68%) was the most common antibody identified followed by lupus anticoagulant (LA) (n = 80, 34.6%) and beta-2-glycoprotein (B2GP) (n = 48, 20.8%). B2GP positivity was associated with higher fetal growth restriction (FGR) (66.7% vs 36.3% vs 32.6%, p value 0.05) and stillbirth (30% vs 9.5% vs 13%, p 0.004) in comparison to ACLA and LA. Multiple antibody positivity was associated with a significantly higher first trimester losses (55.2% first trimester loss in double positive versus 43.2% in single antibody positive group; p 0.004). Thrombotic APS was associated with higher rates of intrauterine growth–restricted fetuses than obstetric APS (35.2% vs 55.9%, p 0.032). ACLA is the most common antibody identified in the APS-positive pregnancies in Southern Indian population. The adverse pregnancy outcomes were higher in multiple antibody positivity and B2GP group.

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抗磷脂抗体综合征妇女的妊娠与临床结果--基于三级医疗中心的观察研究

摘要抗磷脂抗体综合征（APS）是一种累及多系统的获得性血栓性疾病。本研究旨在研究 APS 孕妇的抗体谱及其妊娠结局。这项回顾性研究在印度南部的一家三级医疗教学机构进行。本研究分析了 104 名妇女中 231 例 APS 阳性孕妇的数据。主要结果是研究 APS 并发妊娠的不良后果，如流产、胎儿宫内死亡、新生儿死亡、母体血栓事件和子痫前期。次要结果是研究与各种抗磷脂抗体、原发性与继发性 APS 以及产科与血栓性 APS 相比的不良临床结果。抗心磷脂抗体（ACLA）（n = 157，68%）是最常见的抗体，其次是狼疮抗凝物（LA）（n = 80，34.6%）和β-2-糖蛋白（B2GP）（n = 48，20.8%）。与 ACLA 和 LA 相比，B2GP 阳性与较高的胎儿生长受限（FGR）（66.7% vs 36.3% vs 32.6%，P 值 0.05）和死胎（30% vs 9.5% vs 13%，P 0.004）相关。多重抗体阳性与妊娠头三个月死亡率明显升高有关（双抗体阳性组妊娠头三个月死亡率为 55.2%，单抗体阳性组为 43.2%；P 0.004）。血栓性 APS 与胎儿宫内生长受限的相关性高于产科 APS（35.2% 对 55.9%，P 0.032）。ACLA 是印度南部人群中 APS 阳性妊娠中最常见的抗体。多重抗体阳性和 B2GP 组的不良妊娠结局更高。

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SN Comprehensive Clinical Medicine

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