The impact of various entities of antiphospholipid antibodies positivity on adverse pregnancy outcome. An epidemiological perspective

Spinillo, Arsenio; Bellingeri, Camilla; Maggio, Irene De; Riceputi, Greta; Pandolfi, Maria Paola; Spada, Carolina; Alpini, Claudia; Montecucco, Carlomaurizio; Beneventi, Fausta

doi:10.1016/j.jri.2021.103304

Cited by 4 publications

(15 citation statements)

References 24 publications

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“…Overall, the rate of APO in APS and ncAPS groups in all studies was increased compared with that expected in the general population. [26][27][28] A potential benefit of standard and non-standard APS treatment on pregnancy in n=896 patients with ncAPS was suggested by authors in 6/8 studies 11,[19][20][21][22][23][24][25] with comparable rate of APO in ncAPS and APS patients following standard and non-standard APS therapy. However, the lack of HC group in most studies and the low overall quality of evidence are limitations.…”

Section: Discussionmentioning

confidence: 98%

“…For instance, some authors have proposed that ncAPS is a variant of APS and could be classified as such with the inclusion of non-criteria aPL (such as antiphosphatidylethanolamine, anti-annexin V or antiphosphatidylserine/prothrombin antibodies) in current classification criteria and/or improving the detection of the conventional antibodies using new methodological approaches different from the traditional assays. 38,39 The availability and utility however of these non-criteria aPL assays remains limited 40 and none of the studies we identified 11,[19][20][21][22][23][24][25] used them to define patients with ncAPS.…”

Section: Discussionmentioning

confidence: 99%

“…low 19,22,25 quality evidence, described similar rates of pregnancy outcomes between ncAPS and APS groups after standard and non-standard APS treatments, whilst other two with very low 23 and low 24 quality of evidence did not. Less conclusive is the information about the rate of APO in ncAPS and APS patients before APS treatment.…”

Section: Outcome From Systematic Searchmentioning

confidence: 94%

“…3) of pregnancy outcomes in ncAPS with 1/8 'moderate', 6/8 'low' and 1/8 'very low' quality of evidence according to GRADE. They included 6 cohort and 2 case-control studies (11,(19)(20)(21)(22)(23)(24)(25).…”

Section: Study Selectionmentioning

confidence: 99%

“…Eight studies compared pregnancy outcomes in (n=1042) ncAPS patients with (n=1396) APS and/or (n=920) HC (11,(19)(20)(21)(22)(23)(24)(25). The largest (multicentre, mixed retrospective and prospective) study from the European Registry on Obstetric Antiphospholipid Antibody Syndrome (EUROAPS) examined 1640 (n=640 ncAPS and n=1000 APS) patients (11).…”

Section: Study Selectionmentioning

confidence: 99%

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Comparing pregnancy outcomes in patients with criteria and non-criteria autoimmune disease: A systematic review

Muñoz

Ahmed

Thomas

et al. 2021

Lupus

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Background Not all patients fulfil criteria for specific autoimmune rheumatic diseases (ARDs) and are then defined as having non-criteria (nc)ARD. It is uncertain whether well-recognised associations with adverse pregnancy outcomes in patients with criteria ARD also exist in patients with ncARD or undifferentiated connective tissue disease (UCTD). Therefore, we undertook a systematic review of the prevalence of adverse pregnancy outcomes in various ncARD and UCTD compared with criteria ARD to identify whether there are increased risks and to examine for any benefits of treatment. Methods This study was conducted in accordance with the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. A systematic literature review was performed using online databases including Medline and PubMed from inception to the beginning of April 2021 using appropriate keywords for various ARD and pregnancy outcomes. Results After screening 665 articles, 36 articles were chosen for full text review and 15 selected for final analysis. There were eight studies of nc antiphospholipid syndrome (APS) of more than 7000 pregnancies and seven studies of UCTD of more than 1000 pregnancies. No studies of any other ncARD in pregnancy were identified. We found that patients with either ncAPS or UCTD seem to have an increased burden of poor pregnancy outcomes compared with the general population. Despite the heterogeneity and poor quality of the studies, we also noted that ncAPS and criteria APS patients may have similar rates of obstetric complications with standard and/or non-standard APS treatment regimens. Conclusion Our findings of increased risks of poor pregnancy outcomes in patients with ncAPS or UCTD will be helpful for pre-pregnancy counselling and management of these patients in pregnancy and support their referral to specialist obstetric-rheumatology and obstetric-haematology clinics.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Outcome From Systematic Searchmentioning

confidence: 94%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

See 3 more Smart Citations

Comparing pregnancy outcomes in patients with criteria and non-criteria autoimmune disease: A systematic review

Muñoz

Ahmed

Thomas

et al. 2021

Lupus

View full text Add to dashboard Cite

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The use of hydroxychloroquine in pregnancy and its effect on perinatal outcomes in a population with autoimmune abnormalities

Zhao

Liu

et al. 2022

Clin Rheumatol

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Clinical Features and Outcomes of Twin Pregnancies with Antiphospholipid Antibodies Positivity: A Retrospective Study

Huang,

Wu,

Guo

et al. 2024

RMHP

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This study aimed to evaluate the impact of twin pregnancies with antiphospholipid antibody (aPL) positivity, a rare and complex clinical condition that remains a huge challenge for management. Methods: This study enrolled twin-pregnant women at our hospital between January 2018 and August 2023. Women with and without aPL positivity were selected using propensity score matching (PSM). Clinical features and pregnancy outcomes were compared between the two groups in the PSM cohort. To analyze the effect of aPL positivity on pregnancy outcomes, multivariate logistic models were used to obtain adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among the 773 women with twin pregnancies, aPL positivity was found in 26 women (3.36%). In the PSM cohort, there were 24 twin-pregnant women with positive aPL, and 48 women without aPL were selected as controls. Twin-pregnant women with aPL positivity had a higher proportion of abortion (8.33% vs 0, P = 0.043), preterm birth < 34 weeks (33.33% vs 8.33%, P = 0.007) and very low birthweight (<1500 g) (20.83% vs 4.17%, P = 0.016) than the control group. In addition, stillbirth of one fetus was observed in one twin-pregnant woman with positive aPL. Multivariate logistic regression analysis revealed that twin pregnancy with aPL positivity was associated with preterm birth < 34 weeks (aOR = 2.76, 95% CI: 0.83-4.70, P = 0.005), very low birthweight (<1500 g) (OR = 2.40, 95% CI: 0.18-4.67, P = 0.034) and small for gestational age (SGA) (aOR = 1.66, 95% CI: 0.22-3.10, P =0.024). Conclusion: Twin pregnancies with aPL positivity were correlated with obstetric complications, including abortion, preterm birth < 34 weeks and very low birthweight (<1500 g). The detection of aPL may be of clinical significance for women with twin pregnancies and should be considered in future studies.

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The impact of various entities of antiphospholipid antibodies positivity on adverse pregnancy outcome. An epidemiological perspective

Cited by 4 publications

References 24 publications

Comparing pregnancy outcomes in patients with criteria and non-criteria autoimmune disease: A systematic review

Comparing pregnancy outcomes in patients with criteria and non-criteria autoimmune disease: A systematic review

The use of hydroxychloroquine in pregnancy and its effect on perinatal outcomes in a population with autoimmune abnormalities

Clinical Features and Outcomes of Twin Pregnancies with Antiphospholipid Antibodies Positivity: A Retrospective Study

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