Association of Anticardiolipin Antibodies With Preeclampsia

Prado, Aline Defaveri do; Piovesan, Deise Marcela; Staub, Henrique Luiz; Horta, Bernardo Lessa

doi:10.1097/aog.0b013e3181fe02ec

Cited by 98 publications

(59 citation statements)

References 64 publications

(40 reference statements)

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“…The presence of either of these factors increases the risk of developing preterm preeclampsia by a factor 10 and is associated with other obstetric complications, including recurrent pregnancy loss. 13,14,17,18 This was exemplified by our patient, because her previous 5 pregnancies ended in early miscarriages. In this patient several diagnoses were considered, including lupus nephritis because of the deterioration of renal function for which intravenous methyprednisolone was given.…”

Section: Discussionmentioning

confidence: 96%

Differential Diagnosis of Preeclampsia

et al. 2012

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Section: Discussionmentioning

confidence: 96%

Differential Diagnosis of Preeclampsia

et al. 2012

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“…The presence of these antibodies, in association with venous or arterial thromboses and/or pregnancy complications (e.g., recurrent miscarriages), constitutes antiphospholipid syndrome (APS). Both the presence of antiphospholipid antibodies and APS are frequently seen in association with SLE, with pregnancy complications including fetal loss, which generally occurs after 10 weeks of gestation, and an increased relative risk of pre-eclampsia (50,51). A meta-analysis reported the presence of antiphospholipid antibodies in approximately onequarter of lupus pregnancies (41).…”

Section: Antiphospholipid Antibodies and Antiphospholipid Syndromementioning

confidence: 99%

Obstetric Nephrology

Stanhope

White

Moder

et al. 2012

Clinical Journal of the American Society of Nephrology

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Summary SLE is a multi-organ autoimmune disease that affects women of childbearing age. Renal involvement in the form of either active lupus nephritis (LN) at the time of conception, or a LN new onset or flare during pregnancy increases the risks of preterm delivery, pre-eclampsia, maternal mortality, fetal/neonatal demise, and intrauterine growth restriction. Consequently, current recommendations advise that the affected woman achieve a stable remission of her renal disease for at least 6 months before conception. Hormonal and immune system changes in pregnancy may affect disease activity and progression, and published evidence suggests that there is an increased risk for a LN flare during pregnancy. The major goal of immunosuppressive therapy in pregnancy is control of disease activity with medications that are relatively safe for a growing fetus. Therefore, the use of mycophenolate mofetil, due to increasing evidence supporting its teratogenicity, is contraindicated during pregnancy. Worsening proteinuria, which commonly occurs in proteinuric renal diseases toward the end of pregnancy, should be differentiated from a LN flare and/or preeclampsia, a pregnancy-specific condition clinically characterized by hypertension and proteinuria. These considerations present challenges that underscore the importance of a multidisciplinary team approach when caring for these patients, including a nephrologist, rheumatologist, and obstetrician who have experience with these pregnancyrelated complications. This review discusses the pathogenesis, maternal and fetal risks, and management pertinent to SLE patients with new onset or a history of LN predating pregnancy.

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“…The severity of preeclampsia was not stated in 7 of the publications. Pooled OR for association of aCL antibodies with preeclampsia was 2.9 (95% CI 1.4-5.9) (5) . Pooled OR for aCL antibodies and severe preeclampsia was 11.2 (95 % CI 2.7-46.8).…”

Section: Aps Preeclampsia and The Hellp Syndromementioning

confidence: 99%

“…It was concluded that moderate-to-high levels of aCL antibodies were associated with preeclampsia. There was, however, insufficient evidence to advocate use of aCL antibodies as predictors of preeclampsia (5) .…”

Section: Aps Preeclampsia and The Hellp Syndromementioning

confidence: 99%