Document Detail

The prevalence and biologic significance of lupus anticoagulant and anticardiolipin antibodies in a general obstetric population.
MedLine Citation:
PMID:  2504043     Owner:  NLM     Status:  MEDLINE    
Circulating antibodies to negatively-charged phospholipids have been implicated in the genesis of adverse pregnancy outcomes. However, it has yet to be established that these antibodies are causative or that they are invariably associated with untoward perinatal outcomes. To address this issue, the prevalence of lupus anticoagulant and anticardiolipin antibodies was recorded in a low-risk obstetric population, and the outcome of untreated pregnancies were evaluated. Two of 737 patients (0.27%) had lupus anticoagulant documented by a prolonged activated partial thromboplastin time that did not correct this mixing studies. In comparison, greatly elevated concentrations of immunoglobulin M-anticardiolipin antibodies or immunoglobulin G-anticardiolipin antibodies were identified in 16/737 (2.2%) patients by means of an enzyme-linked immunosorbent assay. Spontaneous abortions occurred in both lupus anticoagulant-positive patients, suggesting that the activated partial thromboplastin time used was a relatively insensitive but specific marker for antiphospholipid antibody-associated adverse pregnancy outcomes. In contrast, although 12 of 16 anticardiolipin antibodies-positive pregnancies were complicated by perinatal loss, preterm delivery, or fetal growth retardation, four patients had uncomplicated pregnancies. Moreover, the distribution of anticardiolipin antibodies concentrations in these four patients was not clustered among the lowest anticardiolipin antibodies values, and anticardiolipin antibodies concentrations correlated weakly with adverse outcomes. These findings suggest that antiphospholipid antibodies are related to adverse pregnancy outcomes in a complex fashion and that therapy is not always required for acceptable outcomes in patients without other risk factors.
C J Lockwood; R Romero; R F Feinberg; L P Clyne; B Coster; J C Hobbins
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  161     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1989 Aug 
Date Detail:
Created Date:  1989-09-13     Completed Date:  1989-09-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  369-73     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
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MeSH Terms
Autoantibodies / analysis*
Blood Coagulation Factors / analysis,  immunology*
Cardiolipins / immunology*
Enzyme-Linked Immunosorbent Assay
Immunoglobulin G / analysis
Immunoglobulin M / analysis
Lupus Coagulation Inhibitor
Lupus Erythematosus, Systemic / immunology*
Partial Thromboplastin Time
Phospholipids / analysis*
Pregnancy Complications / immunology*
Pregnancy Outcome
Risk Factors
Reg. No./Substance:
0/Autoantibodies; 0/Blood Coagulation Factors; 0/Cardiolipins; 0/Immunoglobulin G; 0/Immunoglobulin M; 0/Lupus Coagulation Inhibitor; 0/Phospholipids
Comment In:
Am J Obstet Gynecol. 1990 Aug;163(2):701   [PMID:  2386177 ]
Am J Obstet Gynecol. 1990 Aug;163(2):704-5   [PMID:  2117394 ]

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