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Antiphospholipid antibodies in pregnancy: prevalence and clinical associations
N S Pattison1, L W Chamley, E J McKay
1Department of Obstetrics & Gynaecology, University of Auckland, National Women's Hospital, New Zealand.
Objective:
To determine prevalence, clinical association and predictive power of antiphospholipid antibodies in pregnancy.
Design:
To test for the presence of anticardiolipin antibodies and lupus anticoagulant in order to confirm prevalence data which imply that each antibody has the same clinical significance. A detailed obstetric history and the outcome measures were obtained from each patient in the study.
Setting:
National Women's Hospital, Auckland, New Zealand.
Subjects:
Nine hundred and thirty-three consecutively booked pregnant women.
Main Outcome Measures:
Prevalence of auto-antibodies; perinatal morbidity and mortality; incidence of pre-eclampsia, growth retardation and fetal distress.
Results:
Nine women (1.0%) had anticardiolipin antibodies, 11 (1.2%) had lupus anticoagulant and two had both antibodies. The fetal mortality rate for women with antibodies was 167/1000. Pre-eclampsia occurred significantly more often in women with auto-antibodies.
Conclusion:
The presence of antiphospholipid antibodies is frequently associated with adverse pregnancy outcome (9/18 pregnancies). High titre anticardiolipin antibodies carry a poor prognosis.