Anticorpos antifosfolípides em mulheres com antecedentes de perdas gestacionais: estudo caso-controle

Abstract

Objective: To determine the prevalence of antiphospholipid antibodies in women with pregnancy loss and verify if such antibodies represent a risk factor for pregnancy failure. Methods: We performed a case-control study with 250 pregnant and non-pregnant women, seen at a public maternity between March of 2003 and June of 2004. The women were divided in two groups according to their obstetric past: 100 women with previous pregnancy loss, defined as the obstetric criteria of the antiphospholipid syndrome (cases) and 150 healthy women with record of two or more successful pregnancies (controls). Lupus anticoagulant was determined by aTTP and dRVVT tests. IgG and IgM anticardiolipin antibodies (aCL) were determined by a specific immunoassay (ELISA) and results were expressed as GPL or MPL units. Results: Lupus anticoagulant was positive in 5% of the cases and 2% of the controls (p = 0.27). The IgG aCL antibodies were present in 18% of the cases and 8,7% of the controls (p = 0.028 ;OR = 2.3; IC 95% = 1-53) and IgM aCL in 5% of the cases and 1% of the controls (p = 0,21). Conclusions: Antiphospholipid antibodies were more prevalent in women with pregnancy loss (28%) than in general obstetric population (17%). Women with IgG aCL antibodies have higher chances of pregnancy loss.

Untitled

“…Lemos com interesse o estudo de Costa et al (1) sobre a associação de anticorpos antifosfolípides e perdas fetais. No entanto, na seção Metodologia, os autores descrevem que "(...) trata-se de um estudo caso-controle prospectivo (...)" e, em nosso entendimento, esta definição é inadequada.…”