| Prediction of adverse pregnancy outcome by the presence of lupus anticoagulant, but not anticardiolipin antibody, in patients with antiphospholipid antibodies. | |
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MedLine Citation:
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PMID: 22275304 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate which serologic and clinical findings predict adverse pregnancy outcome in patients with antiphospholipid antibody (aPL) and to test the hypothesis that a pattern of clinical and serologic variables can identify women at highest risk of adverse pregnancy outcome. METHODS: Women enrolled in a multicenter prospective observational study of risk factors for adverse pregnancy outcome in patients with aPL (lupus anticoagulant [LAC], anticardiolipin antibody [aCL], and/or antibody to β2-glycoprotein I [anti-β2 GPI]) and/or systemic lupus erythematosus (SLE) were recruited for the present prospective study. Demographic, clinical, serologic, and treatment data were recorded at the time of the first study visit. The relationship between individual and combined variables and adverse pregnancy outcome was assessed by bivariate and multivariate analysis. RESULTS: Between 2003 and 2011 we enrolled 144 pregnant patients, of whom 28 had adverse pregnancy outcome. Thirty-nine percent of the patients with LAC had adverse pregnancy outcome, compared to 3% of those who did not have LAC (P<0.0001). Among women with IgG aCL at a level of ≥40 units/ml, only 8% of those who were LAC negative had adverse pregnancy outcome, compared to 43% of those who were LAC positive (P=0.002). IgM aCL, IgG anti-β2 GPI, and IgM anti-β2 GPI did not predict adverse pregnancy outcome. In bivariate analysis, adverse pregnancy outcome occurred in 52% of patients with and 13% of patients without prior thrombosis (P=0.00005), and in 23% with SLE versus 17% without SLE (not significant); SLE was a predictor in multivariate analysis. Prior pregnancy loss did not predict adverse pregnancy outcome. Simultaneous positivity for aCL, anti-β2 GPI, and LAC did not predict adverse pregnancy outcome better than did positivity for LAC alone. CONCLUSION: LAC is the primary predictor of adverse pregnancy outcome after 12 weeks' gestation in aPL-associated pregnancies. Anticardiolipin antibody and anti-β2 GPI, if LAC is not also present, do not predict adverse pregnancy outcome. |
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Authors:
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Michael D Lockshin; Mimi Kim; Carl A Laskin; Marta Guerra; D Ware Branch; Joan Merrill; Michelle Petri; T Flint Porter; Lisa Sammaritano; Mary D Stephenson; Jill Buyon; Jane E Salmon |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Arthritis and rheumatism Volume: 64 ISSN: 1529-0131 ISO Abbreviation: Arthritis Rheum. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-06-28 Completed Date: 2012-09-14 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0370605 Medline TA: Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 2311-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 by the American College of Rheumatology. |
Affiliation:
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Hospital for Special Surgery and Weill Cornell Medical College, New York, New York. lockshinm@hss.edu. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antibodies, Anticardiolipin / blood*, immunology Antiphospholipid Syndrome / blood*, immunology Female Humans Lupus Coagulation Inhibitor / blood*, immunology Predictive Value of Tests Pregnancy Pregnancy Complications / blood*, immunology Pregnancy Outcome Prospective Studies Risk Factors |
| Grant Support | |
ID/Acronym/Agency:
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R01 AR049772/AR/NIAMS NIH HHS; R01 AR049772-08/AR/NIAMS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Anticardiolipin; 0/Lupus Coagulation Inhibitor |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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