Document Detail

Observational study of pregnant women with a previous spontaneous abortion before the 10th gestation week with and without antiphospholipid antibodies.
MedLine Citation:
PMID:  20088936     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A clinical subtype of purely obstetrical antiphospholipid antibody (aPL-Ab) syndrome (APS) requires three or more unexplained consecutive embryonic losses before the 10th week of gestation associated with persistently positive lupus anticoagulant (LAC), and/or anticardiolipin IgG or IgM, and/or anti-beta2-glycoprotein I (abeta2GpI) IgG or IgM. Although this diagnostic classification of APS appeared to be the most sensitive, the APS-associated serological criteria are still debated. PATIENTS/METHODS: We prospectively observed the second pregnancy of 284 women with a previous embryonic loss, both with and without aPL-Ab. RESULTS: aPL-Ab-positive women were more prone to pregnancy loss, embryonic loss, pre-eclampsia, placental abruption and intrauterine fetal growth restriction. Type IIa aPL-Ab positivity (LAC present alone) was associated with the highest risk of recurrent embryonic loss and intrauterine growth restriction. Type I aPL-Ab positivity (combinations of aPL-Ab type positivity) was associated with the strongest risks of late complications, pre-eclampsia and placental abruption. Finally, abeta2GpI-M positivities were not clinically relevant in these women. CONCLUSION: Patients with a first unexplained pregnancy loss before the 10th week of gestation who are also positive for aPL-Abs have a higher risk of various complications in their second pregnancy. In this study, measurement of abeta2GpI-M had a questionable prognostic value.
C Chauleur; J-P Galanaud; S Alonso; E Cochery-Nouvellon; J-P Balducchi; P Marès; P Fabbro-Peray; J-C Gris
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-17
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  8     ISSN:  1538-7836     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  699-706     Citation Subset:  IM    
Research Team EA2992, Montpellier University 1, Nîmes, France.
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MeSH Terms
Abortion, Spontaneous / immunology*
Abruptio Placentae / immunology
Antibodies, Anticardiolipin / blood
Antibodies, Antiphospholipid / blood*
Antiphospholipid Syndrome / complications,  immunology*
Case-Control Studies
Chi-Square Distribution
Embryo Loss / immunology
Fetal Growth Retardation / immunology
Gestational Age
Logistic Models
Lupus Coagulation Inhibitor / blood
Odds Ratio
Pre-Eclampsia / immunology
Pregnancy Complications / immunology*
Prospective Studies
Risk Assessment
Risk Factors
Young Adult
beta 2-Glycoprotein I / immunology
Reg. No./Substance:
0/Antibodies, Anticardiolipin; 0/Antibodies, Antiphospholipid; 0/Lupus Coagulation Inhibitor; 0/beta 2-Glycoprotein I

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