Characterization of antiphospholipid antibodies in women with recurrent spontaneous abortions

Antiphospholipid antibodies are important in the etiology of recurrent pregnancy loss. To date, most studies have concentrated on antibodies to cardiolipin specifically. In this study, the serum of 352 women with recurrent pregnancy loss was studied by enzyme-linked immunosorbent assay for antibodies to six phospholipid epitopes: cardiolipin, phosphoserine, phosphoglycerol, phosphoethanolamine, phosphatidic acid and phosphoinositol. Of these women, 59.1% had either an IgG or IgM antibody to one of the six phospholipids. This compared to only 4.6% in the control group. Approximately 75% of the isotypes were IgM. The most common phospholipid epitope was phosphoserine. However, in patients with antibodies to only one phospholipid, phosphoethanolamine was the most common. These findings support recent evidence that antiphospholipid antibodies may interfere with the formation of syncytiotrophoblasts in the placenta. In addition, antiphospholipid antibodies occur more frequently in patients who suffer recurrent miscarriages than was previously thought.