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Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, LLurba E, Ruffatti A, Tincani A, Lefkou E, Bertero MT, Espinosa G, de Carolis S, Rovere-Querini P, Lundelin K, Picardo E, Mekinian A. Comparative study between obstetric antiphospholipid syndrome and obstetric morbidity related with antiphospholipid antibodies. Med Clin (Barc) 2017; 151:215-222. [PMID: 29274674 DOI: 10.1016/j.medcli.2017.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES To compare clinical, laboratory, treatment and live birth rate data between women with aPL-related obstetric complications (OMAPS) not fulfilling the Sydney criteria and women fulfilling them (OAPS). MATERIALS AND METHODS Retrospective and prospective multicentre study. Data comparison between groups from The European Registry on Antiphospholipid Syndrome included within the framework of the European Forum on Antiphospholipid Antibody projects. RESULTS 338 women were analysed: 247 fulfilled the Sydney criteria (OAPS group) and 91 did not (OMAPS group). In the OMAPS group, 24/91 (26.37%) fulfilled laboratory Sydney criteria (subgroup A) and 67/91 (74.63%) had a low titre and/or non-persistent aPL-positivity (subgroup B). Overall, aPL laboratory categories in OAPS vs. OMAPS showed significant differences: 34% vs. 11% (p<0.0001) for category I, 66% vs. 89% (p<0.0001) for category II. No differences were observed when current obstetric complications were compared (p=0.481). 86.20% of OAPS women were treated vs. 75.82% of OMAPS (p=0.0224), particularly regarding the LDA+LMWH schedule (p=0.006). No differences between groups were observed in live births, gestational, puerperal arterial and/or venous thrombosis. CONCLUSIONS Significant differences were found among aPL categories between groups. Treatment rates were higher in OAPS. Both OAPS and OMAPS groups had similarly good foetal-maternal outcomes when treated. The proposal to modify OAPS classification criteria, mostly laboratory requirements, is reinforced by these results.
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Affiliation(s)
- Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autonoma, Barcelona, Spain.
| | - Enrique Esteve-Valverde
- Internal Medicine Department, Althaia Healthcare Network of Manresa, Rheumatology Unit, Barcelona, Spain
| | - Raquel Ferrer-Oliveras
- Obstetrics and Gynaecology Department, High Risk Unit, Vall d'Hebron University Hospital, Universitat Autonoma, Barcelona, Spain.
| | - Elisa LLurba
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Amelia Ruffatti
- Rheumatology Unit, Department of Clinical and Experimental Medicine Azienda Ospedaliera, University of Padua, Padua, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Ospedale Civile, Brescia, Italy
| | - Elmina Lefkou
- Haematology Unit, Hippokration Hospital of Thessaloniki, Greece
| | - Mª Tiziana Bertero
- Department of Clinical Immunology, A.O. Mauriziano-Umberto I, Turin, Italy
| | - Gerard Espinosa
- Systemic Autoimmune Diseases Service, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Sara de Carolis
- Department of Gynaecology, Gemmeli Hospital, Catholic University, Roma, Italy
| | - Patrizia Rovere-Querini
- Scuola di Specializzazione in Allergologia e Immunolofia Clinica, U.O. Medicina ad indrizzo Immunlogico Clinico-Ospedale San Raffaele, Milano, Lab, Autoimminità e inflammazione vascolare - San Raffaele DIBIT, Milano, Italy
| | - Krista Lundelin
- Internal Medicine Department, Hospital Universitario La Paz, Universidad Autònoma, Madrid, Spain
| | - Elisa Picardo
- Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy
| | - Arsene Mekinian
- AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ Paris 06, F-75012, Paris, France
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