RT Journal Article
SR Electronic
T1 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’)
JF Lupus Science & Medicine
JO Lupus Sci Med
FD Lupus Foundation of America
SP e000633
DO 10.1136/lupus-2021-000633
VO 9
IS 1
A1 Zeynep Belce Erton
A1 Ecem Sevim
A1 Guilherme Ramires de Jesús
A1 Ricard Cervera
A1 Lanlan Ji
A1 Vittorio Pengo
A1 Amaia Ugarte
A1 Danieli Andrade
A1 Laura Andreoli
A1 Tatsuya Atsumi
A1 Paul R Fortin
A1 Maria Gerosa
A1 Yu Zuo
A1 Michelle Petri
A1 Savino Sciascia
A1 Maria G Tektonidou
A1 Maria Angeles Aguirre- Zamorano
A1 D Ware Branch
A1 Doruk Erkan
A1 ,
YR 2022
UL http://lupus.bmj.com/content/9/1/e000633.abstract
AB 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.No data are available. Not applicable. No data are available.