Low complement levels are related to poor obstetric outcomes in women with obstetric antiphospholipid syndrome. The EUROAPS Registry Study Group

被引:8
作者
Esteve-Valverde, Enrique [1 ]
Alijotas-Reig, Jaume [2 ,3 ,4 ]
Belizna, Cristina [5 ,6 ]
Marques-Soares, Joana [3 ]
Anunciacion-Llunell, Ariadna [2 ]
Feijoo-Masso, Carlos [1 ]
Saez-Comet, Luis [7 ]
Mekinian, Arsene [8 ,9 ]
Ferrer-Oliveras, Raquel [10 ]
Lefkou, Elmina [11 ]
Morales-Perez, Stephanie [12 ]
Hoxha, Ariel [13 ]
Tincani, Angela [14 ]
Nalli, Cecilia [14 ]
Pardos-Gea, Josep [2 ,3 ]
Marozio, Luca [15 ]
Maina, Aldo [16 ]
Espinosa, Gerard [17 ]
Cervera, Ricard [17 ]
De Carolis, Sara [18 ]
Latino, Omar [19 ]
Udry, Sebastian [19 ]
Llurba, Elisa [20 ]
Garrido-Gimenez, Carmen [20 ]
Trespidi, Laura [21 ]
Gerosa, Maria [22 ]
Chighizola, Cecilia B. [22 ]
Rovere-Querini, Patrizia [23 ]
Canti, Valentina [23 ]
Mayer-Pickel, Karoline [24 ]
Tabacco, Sara [25 ]
Arnau, Anna [26 ]
Miro-Mur, Francesc [2 ]
机构
[1] Hosp Univ Parc Tauli, Dept Internal Med, Syst Autoimmune Dis Unit, Sabadell, Spain
[2] Vall DHebron Inst Recerca VHIR, Syst Autoimmune Dis Res Unit, Barcelona, Spain
[3] Vall DHebron Univ Hosp, Dept Internal Med, Syst Autoimmune Dis Unit, Barcelona, Spain
[4] Univ Autonoma Barcelona, Fac Med, Dept Med, Barcelona, Spain
[5] Univ Hosp Angers, Vasc & Coagulat Dept, Angers, France
[6] CNRS, INSERM, 1083 Unit, Angers, France
[7] Miguel Servet Univ Hosp, Internal Med Dept, Zaragoza, Spain
[8] UPMC Univ, Sorbonne Univ, Hop St Antoine, AP HP,Serv Med Interne, Paris, France
[9] UPMC Univ, Sorbonne Univ, Inflammat Immunopathol Biotherapy Dept DHU I2B, Paris, France
[10] Hosp Quiron, Obstet & Gynaecol Dept, Barcelona, Spain
[11] Hippokrat Hosp Thessaloniki, Haematol Unit, Thessaloniki, Greece
[12] Althaia Healthcare Univ Network Manresa, Internal Med Dept, Syst Autoimmune Dis Unit, Barcelona, Spain
[13] Univ Padua, Dept Med DIMED, Rheumatol Unit, Padua, Italy
[14] Univ Brescia, Dept Clin & Expt Sci, Rheumatol & Clin Immunol Unit, Brescia, Italy
[15] Univ Turin, Dept Obstet & Gynaecol, Turin, Italy
[16] AO Citta Salute & Sci Torino, Dept Internal Med, Turin, Italy
[17] Univ Barcelona, Hosp Clin, Inst Recerca Biomed August Pi & Sunyer IDIBAPS, Dept Autoimmune Dis, Barcelona, Spain
[18] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Salute Donna Bambino & Sanita Pu, UOC Patol Ostetr, Rome, Italy
[19] Dr Carlos G Durand Hosp, Autoimmune Thrombophil Dis & Pregnancy Div, Buenos Aires, DF, Argentina
[20] Univ Hosp La Santa Creu & St Pau, Obstet & Gynaecol Dept, High Risk Unit, Barcelona, Spain
[21] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Obstet & Gynaecol Dept, Milan, Italy
[22] Univ Milan, Dept Clin Sci & Community Hlth, Div Rheumatol, Milan, Italy
[23] Univ Vita Salute San Raffaele, Unit Med & Clin Immunol, Pregnancy & Rheumat Dis Clin, IRCCS Osped San Raffaele, Milan, Italy
[24] Med Univ Graz, Dept Obstet, Graz, Austria
[25] Sapienza Univ Rome, Dept Gynecol Obstet & Urol, Rome, Italy
[26] Althaia Xarxa Assistencial Univ Manresa, Res & Innovat Unit, Manresa, Spain
关键词
Antiphospholipid antibody; Antiphospholipid syndrome; Obstetric antiphospholipid syndrome; C3; complement; C4; Hypocomplementemia; PREGNANCY; RECEPTORS; C3B;
D O I
10.1016/j.placenta.2023.04.001
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Introduction: Obstetric antiphospholipid syndrome (OAPS) is an autoimmune disease related to antiphospholipid antibodies (aPL) with primaryinflammatory injury followed by clot cascade activation and thrombus formation. Complement system activation and their participation in aPL-related thrombosis is unclosed.Methods: We haveanalysed adverse pregnancy outcomes (APO) related to low complement (LC) levels in a cohort of 1048 women fulfilling classification criteria for OAPS.Results: Overall, 223 (21.3%) women presented LC values, during pregnancy. The length of pregnancy was shorter in OAPS women with LC compared to those with normal complement (NC) (median: 33 weeks, inter-quartile range: [24-38] vs. 35 weeks [27-38]; p = 0.022). Life new-born incidence was higher in patients with NC levels than in those with LC levels (74.4% vs. 67.7%; p = 0.045). Foetal losses were more related to women with triple or double aPL positivity carrying LC than NC values (16.3% vs. 8.0% NC; p = 0.027). Finally, some placental vasculopathies were affected in OAPS patients with LC as late Foetal Growth Restriction (FGR >34 weeks) rise to 7.2% in women with LC vs. 3.2% with NC (p = 0.007).Discussion: Data from our registry indicate that incidence of APO was higher in OAPS women with LC levels and some could be reverted by the correct treatment.
引用
收藏
页码:29 / 34
页数:6
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