The association of antiphospholipid antibodies with intrauterine fetal death: A case-control study

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• 作者：Linda Bjö ; rk Helgadottir^a ; ^b ; ^c ; ^{linda_bjork_helgadottir@hotmail.com} ; Finn Egil Skjeldestad^a ; ^d ; Anne Flem Jacobsen^b ; Per Morten Sandset^a ; ^c ; Eva-Marie Jacobsen^a ; ^c
• 关键词：APAs ; antiphospholipid antibodies ; PMPC ; placenta mediated pregnancy complications ; aCL ; anticardiolipin antibodies ; IgG ; immunoglobulin G isotype ; LA ; lupus anticoagulant ; IUFD ; intrauterine fetal death ; VIP ; the Venous Thromboembolism In Pregnancy study
• 刊名：Thrombosis Research
• 出版年：2012
• 期刊代码：247_00493848
• 类别：med
• 出版时间：July, 2012
• 卷：130
• 期：1
• 页码：32-37
• 文件大小：248 K

摘要

Introduction

Over the past few decades it has been recognized that antiphospholipid antibodies are associated with pregnancy loss. Other placenta-mediated pregnancy complications have also been associated with the presence of antiphospholipid antibodies. Most studies have measured antiphospholipid antibodies near the time of the event investigated.

Objectives

To investigate the association of antiphospholipid antibodies and a history of intrauterine fetal death (IUFD) in a case-control design.

Materials and methods

A case-control study of 105 women with a history of IUFD after 22 gestational weeks and 262 controls with live births. The prevalence of lupus anticoagulant, anticardiolipin- and anti-尾2-glycoprotein 1 antibodies were measured 3-18 years after the event of IUFD.

Results

Total 9.5%of women with a history of IUFD and 5.0%of controls had at least one positive test for antiphospholipid antibodies (OR 2.0; 95%confidence interval (CI) 0.9-4.8). Women with a history of IUFD were significantly more often positive for lupus anticoagulant compared to controls (OR 4.3; 95%CI 1.0-18.4). The association of lupus anticoagulant with a history of IUFD was confined to women positive for other antiphospholipid antibodies in addition to lupus anticoagulant. Being positive for anti-尾2-glycoprotein 1 or anticardiolipin antibodies alone was not significantly associated with a history of IUFD.

Conclusions

Women with a history of IUFD after 22 gestational weeks were more often lupus anticoagulant positive. The association was confined to women with multiple positivity for antiphospholipid antibodies, although firm conclusions on the importance of multiple positivity cannot be made from this study.