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PO.2.39 Long term follow up of patients with primary obstetric antiphospholipid syndrome
  1. S Niznik1,
  2. M Rapoport2,
  3. O Avnery3,
  4. M Ellis3,
  5. A Lubetsky4,
  6. R Shavit1 and
  7. N Agmon-Levin1
  1. 1Allergy and Clinical Immunology Unit, Sheba Medical Center ~ Ramat Gan ~ Israel
  2. 2Internal Medicine C, Shamir Medical Center ~ Zrifin ~ Israel
  3. 3Hematology Institute and Blood Bank, Meir Medical Center ~ Kfar Saba ~ Israel
  4. 4The National Hemophilia Center and Thrombosis Unit, Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center ~ Ramat Gan ~ Israel


Introduction Primary obstetric antiphospholipid syndrome (OAPS) is defined by specific morbidities and/or losses of pregnancy in the presence of persistent antiphospholipid antibodies (aPL). This variant of APS is usually treated during pregnancy and the post-partum period. Data on occurrence of thrombotic event during long term follow-up of OAPS patients is limited.

Methods A multi-center retrospectively cohort of female patients with primary APS (pAPS) was assembled during 2004–2019. Patients were grouped according to disease presentation as pure OAPS or thrombotic APS (tAPS) for those presenting with thrombosis. Clinical and serological data were compared between groups.

Results Of 219 pAPS female patients 67 (30.6%) were diagnosed with OAPS and 152 (69.4%) with tAPS. During >10 years of follow-up 24/67 (35.8%) OAPS and 71/152 (50%) tAPS suffered a new thrombotic event (p = 0.06), while obstetric morbidity was more likely in the OAPS group (31.3 vs. 10.5%, p < 0.001) respectively. Among patients with OAPS at presentation heart valve disease and the presence of ANA were related to thrombosis following diagnosis (25 vs. 4.7%, p = 0.02; and 45.8 vs. 20.8%, p = 0.04 respectively).

Conclusion Thrombotic event following diagnosis were common among female patients with pAPS regardless of disease presentation. Heart valve disease and ANA positivity may be risk factors for thrombosis during follow-up of patients presenting with pure OAPS.

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