Document Detail


Relationship of antiphospholipid antibodies to pregnancy loss in patients with systemic lupus erythematosus: a cross-sectional study.
MedLine Citation:
PMID:  1498338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine whether an association exists between the presence of antiphospholipid antibodies and pregnancy loss, a cross-sectional study was performed. Consecutive women who were referred to three outpatient rheumatology clinics and who had systemic lupus erythematosus (SLE) and a history of one or more pregnancies were evaluated. Patients were interviewed to determine outcomes of all previous pregnancies. Blood was taken on two separate occasions at least 3 months apart to test for the presence of the lupus anticoagulant and anticardiolipin antibodies; on both occasions, five tests of the lupus anticoagulant, with well-defined normal ranges, and an enzyme-linked immunosorbent assay to measure IgG anticardiolipin antibodies were performed. Patients were considered to be positive for the lupus anticoagulant if one or more tests was abnormal on both occasions and positive for anticardiolipin antibodies if the test was abnormal on both occasions. Forty-two women were studied. Statistically significant associations were shown between lupus anticoagulant positivity and previous pregnancy loss (odds ratio [OR], 4.8; 95% confidence intervals [CI], 1.0 to 23.6; P = .05) and between anticardiolipin antibody positivity and previous pregnancy loss (OR, 20.0; 95% CI, 1.3 to 97.0; P = .01). All seven women with multiple episodes of pregnancy loss were lupus anticoagulant positive and four of these were also anticardiolipin antibody positive. If patients who are transiently positive for lupus anticoagulant and/or anticardiolipin antibodies are considered to be test positive, the associations with pregnancy loss are no longer statistically significant. Within the group of lupus anticoagulant-positive patients, we observed stronger associations between the presence of six or more positive tests and pregnancy loss than between the presence of two to five positive tests and pregnancy loss. No single test for the lupus anticoagulant provides a statistically significant association with pregnancy loss. The results of our study show that by performing multiple lupus anticoagulant tests and by repeating testing for lupus anticoagulant and anticardiolipin antibodies on more than one occasion, significant associations between the presence of antiphospholipid antibodies and previous pregnancy loss can be shown in patients with SLE.
Authors:
J S Ginsberg; P Brill-Edwards; M Johnston; J A Denburg; M Andrew; R F Burrows; W Bensen; A Cividino; A A Long
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood     Volume:  80     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-14     Completed Date:  1992-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  975-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / immunology*
Adrenal Cortex Hormones / therapeutic use
Antiphospholipid Syndrome / immunology*
Autoantibodies / blood*
Cardiolipins / immunology
Cross-Sectional Studies
Female
Humans
Lupus Coagulation Inhibitor / blood
Lupus Erythematosus, Systemic / immunology*
Phospholipids / immunology*
Pregnancy
Pregnancy Complications / immunology*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Autoantibodies; 0/Cardiolipins; 0/Lupus Coagulation Inhibitor; 0/Phospholipids
Comments/Corrections
Comment In:
Blood. 1992 Aug 15;80(4):859-62   [PMID:  1498328 ]

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