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High positive antibody titers and adverse pregnancy outcome in women with antiphospholipid syndrome.
MedLine Citation:
PMID:  21729009     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To investigate whether in patients with antiphospholipid syndrome (APS), high positive antibody titers are associated with adverse pregnancy outcome. Design. A retrospective cohort of prospectively collected data. Setting. Sheba Medical Center, Israel, a tertiary referral center. Population sample. Pregnant women with APS. Methods. Anticardiolipin, a-β2- glycoprotein I antibodies, and lupus anticoagulant were measured before pregnancy. Women were divided into those with antibody titers >4 times upper limit of normal (high positive titer, HPT group), and the rest, the positive titer (PT) group. All women were treated with daily enoxaparine and aspirin. Main outcome measures. Composite adverse fetal/neonatal outcome, defined as one or more of the following: fetal/neonatal loss, preterm birth ≤32 weeks, and birthweight less than 10th percentile. Composite adverse fetal/neonatal outcome was compared between the HPT and PT groups. Maternal adverse outcomes were also compared. Results. 51 women with APS were followed during 55 pregnancies, 20 in the HPT and 35 in the PT groups. The two groups were similar with regards to previous obstetric and clinical characteristics. Among HPT women, only 7/20 (35%) pregnancies culminated in appropriately-grown, live born infants >32 wks gestation, compared with 27/35 (77%) PT pregnancies. The risk of adverse fetal/neonatal outcome was 5.7 times higher (95% CI 1.9-17.7) for HPT, compared with PT women. Conclusions. Pregnant women with APS and high positive antiphospholipid antibody titers are a unique and extremely high risk group for adverse fetal/neonatal outcome. Stricter surveillance and, possibly, additional therapy options should be explored for this patient population.
Authors:
Michal J Simchen; Mordechai Dulitzki; Guy Rofe; Hagit Shani; Pnina Langevitz; Eyal Schiff; Rachel Pauzner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-5
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Departments of Obstetrics and Gynecology, Rheumatology Unit, and Department of Medicine E, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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