Pregnancy outcomes in antiphospholipid antibody positive patients: prospective results from the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository ('Registry')

被引:23
作者
Erton, Zeynep Belce [1 ]
Sevim, Ecem [2 ,3 ]
de Jesus, Guilherme Ramires [4 ,5 ]
Cervera, Ricard [6 ]
Ji, Lanlan [7 ]
Pengo, Vittorio [8 ]
Ugarte, Amaia [9 ]
Andrade, Danieli [10 ]
Andreoli, Laura [11 ,12 ]
Atsumi, Tatsuya [13 ]
Fortin, Paul R. [14 ]
Gerosa, Maria [15 ]
Zuo, Yu [16 ]
Petri, Michelle [17 ]
Sciascia, Savino [18 ,19 ]
Tektonidou, Maria G. [20 ]
Aguirre-Zamorano, Maria Angeles [21 ]
Branch, D. Ware [22 ,23 ]
Erkan, Doruk [24 ]
机构
[1] Hosp Special Surg, Div Rheumatol, 535 E 70th St, New York, NY 10021 USA
[2] Yeshiva Univ Albert Einstein Coll Med, Med, 1300 Morris Pk Ave, Bronx, NY 10461 USA
[3] Montefiore Med Ctr, Internal Med, 111 E 210th St, Bronx, NY 10467 USA
[4] Univ Estado Rio de Janeiro, Dept Obstet, Rio De Janeiro, Brazil
[5] Inst Fernandes Figueira FIOCRUZ, Dept Obstet, Rio De Janeiro, RJ, Brazil
[6] Hosp Clin Barcelona, Autoimmune Dis, Inst Clin Med & Dermatol, Barcelona, Spain
[7] Peking Univ First Hosp, Dept Rheumatol & Clin Immunol, Beijing, Peoples R China
[8] Univ Padua, Cardiac Thorac & Vasc Sci, Padua, Italy
[9] Hosp Cruces, Internal Med, Baracaldo, Spain
[10] Univ Sao Paulo, Rheumatol, Sao Paulo, SP, Brazil
[11] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy
[12] ASST Spedali Civili Brescia, Unit Rheumatol & Clin Immunol, Brescia, Italy
[13] Hokkaido Univ, Med 2, Sch Med, Sapporo, Hokkaido, Japan
[14] Ctr Hosp Univ Laval, Med Rheumatol, Quebec City, PQ, Canada
[15] Univ Milan, Div Rheumatol, Dept Clin & Community Sci, Milan, Italy
[16] Univ Michigan, Div Rheumatol, Internal Med, Ann Arbor, MI 48109 USA
[17] Johns Hopkins Univ, Rheumatol, Baltimore, MD USA
[18] Osped Torino Nord Emergenza San G Bosco, Dipartimento Malattie Rare Immunol Ematol Immunoe, Ctr Ric Immunopatol & Documentaz Malattie Rare CM, Struttura Complessa Direz,Univ Immunol Clin, Turin, Italy
[19] Univ Torino, Turin, Italy
[20] Natl & Kapodistrian Univ Athens, Dept Propaedeut Internal Med 1, Athens, Greece
[21] Univ Hosp Reina Sofia, Rheumatol, Cordoba, Spain
[22] Univ Utah, Hlth Sci Ctr, Maternal Fetal Med, Salt Lake City, UT USA
[23] Intermt Healthcare, Maternal Fetal Med, Salt Lake City, UT USA
[24] Weill Cornell Med, Hosp Special Surg, Barbara Volcker Ctr Women & Rheumat Dis, Rheumatol, New York, NY 10021 USA
来源
LUPUS SCIENCE & MEDICINE | 2022年 / 9卷 / 01期
基金
美国国家卫生研究院;
关键词
antibodies; antiphospholipid; antiphospholipid syndrome; anticardiolipin; LUPUS ANTICOAGULANT; THROMBOSIS; WOMEN;
D O I
10.1136/lupus-2021-000633
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives To describe the outcomes of pregnancies in antiphospholipid antibody (aPL)-positive patients since the inception of the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Registry. Methods We identified persistently aPL-positive patients recorded as 'pregnant' during prospective follow-up, and defined 'aPL-related outcome' as a composite of: (1) Preterm live delivery (PTLD) at or before 37th week due to pre-eclampsia (PEC), eclampsia, small-for-gestational age (SGA) and/or placental insufficiency (PI); or (2) Otherwise unexplained fetal death after the 10th week of gestation. The primary objective was to describe the characteristics of patients with and without aPL-related composite outcomes based on their first observed pregnancies following registry recruitment. Results Of the 55 first pregnancies observed after registry recruitment among nulliparous and multiparous participants, 15 (27%) resulted in early pregnancy loss <10 weeks gestation. Of the remaining 40 pregnancies: (1) 26 (65%) resulted in term live delivery (TLD), 4 (10%) in PTLD between 34.0 weeks and 36.6 weeks, 5 (12.5%) in PTLD before 34th week, and 5 (12.5%) in fetal death (two associated with genetic anomalies); and (2) The aPL-related composite outcome occurred in 9 (23%). One of 26 (4%) pregnancies with TLD, 3/4 (75%) with PTLD between 34.0 weeks and 36.6 weeks, and 3/5 (60%) with PTLD before 34th week were complicated with PEC, SGA and/or PI. Fifty of 55 (91%) pregnancies were in lupus anticoagulant positive subjects, as well as all pregnancies with aPL-related composite outcome. Conclusion In our multicentre, international, aPL-positive cohort, of 55 first pregnancies observed prospectively, 15 (27%) were complicated by early pregnancy loss. Of the remaining 40 pregnancies, composite pregnancy morbidity was observed in 9 (23%) pregnancies.
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页数:10
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