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'). Issue 1 (14th June 2022)

• Record Type: Journal Article
• Authors: Erton, Zeynep Belce; Sevim, Ecem; de Jesús, Guilherme Ramires; Cervera, Ricard; Ji, Lanlan; Pengo, Vittorio; Ugarte, Amaia; Andrade, Danieli; Andreoli, Laura; Atsumi, Tatsuya; Fortin, Paul R; Gerosa, Maria; Zuo, Yu; Petri, Michelle; Sciascia, Savino; Tektonidou, Maria G; Aguirre- Zamorano, Maria Angeles; Branch, D Ware; Erkan, Doruk
• Other Names: author non-byline.; Lockshin Michael author non-byline.; Salmon Jane author non-byline.; Barbhaiya Medha author non-byline.; Tincani Angela author non-byline.; Nalli Cecilia author non-byline.; Willis Rohan author non-byline.; Gonzalez Emilio author non-byline.; Levy Roger author non-byline.; Meroni Pierluigi author non-byline.; Chighizola Cecilia B author non-byline.; Balbi Gustavo author non-byline.; Ruiz-Irastorza Guillermo author non-byline.; Zhang Zhuoli author non-byline.; Rodriguez-Pinto Ignasi author non-byline.; Amengual Olga author non-byline.; Wahl Denis author non-byline.; Zuily Stephane author non-byline.; Bertolaccini Maria Laura author non-byline.; Cohen Hannah author non-byline.; Mackie Ian author non-byline.; Efthymiou Maria author non-byline.; Almaraz Esther Rodgriguez author non-byline.; Belmont Michael author non-byline.; Knight Jason author non-byline.; Foddai Silvia author non-byline.; Lopez-Pedrera Rosario author non-byline.; Artim-Esen Bahar author non-byline.; Pons-Estel Guillermo author non-byline.; Kello Nina author non-byline.; Clarke Ann author non-byline.; Skeith Leslie author non-byline.; Pardos-Gea Jose author non-byline.; Signorelli Flavio author non-byline.; Zuily Stephane author non-byline.; Radin Massimo author non-byline.; Davis Stacy author non-byline.; Roubey Robert author non-byline.; Zhang Zhouli author non-byline.; Pazzola Giulia author non-byline.;
• Is Part Of: Lupus science & medicine. Volume 9:Issue 1(2022)
• Publication Date: 2022-06-14
• Subjects: antibodies, antiphospholipid -- antiphospholipid syndrome -- antibodies, anticardiolipin; Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1136/lupus-2021-000633
• Languages: English
• ISSNs: 2398-8851

Abstract

Abstract : 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.