CoChat
Sign Up
Cited by 35Systemic Lupus Erythematosus ResearchReproductive System and PregnancyPregnancy and preeclampsia studies

Pregnancy outcome in women with antiphospholipid antibodies: report on a retrospective study

Open access
Heilmann, Lothar, Schorch, Martin, Hahn, Thomas, Adasz, Geza, Schilberz, Karin, Adiguzel, Cafer, Fareed, Jawed·2008·Seminars in Thrombosis and Hemostasis
DOI 10.1055/s-0029-1145261
Open this paper in CoChat — free accountOpen PDF

Abstract

Antiphospholipid syndrome (APS) represents a serious risk factor in pregnancy resulting in several complications, leading to fetal loss and hemostatic complications. In this dedicated report, we describe our experiences in the treatment of pregnancies in patients with APS. The retrospective data from 140 pregnant women were investigated, and the treatment results of 121 patients were recorded. We studied two groups of patients receiving different treatment. The first group (N = 78) received the standard therapy with low-weight-molecular heparin (dalteparin 5000 U or certoparin 3000 U daily) and aspirin (100 mg daily) and in the second group (N = 43) an additional 0.2 g/kg intravenous immunoglobulin (IVIG). Outcomes were 74.3% and 83.7% live births in the first group and in the second group, respectively. The abortion rate was similar in both groups (11.5% vs. 11.6%). The late complication rate was lower in the second group (5.8% vs. 14.1%, P < 0.05) than in the group with standard therapy. Interestingly, we found a trend to higher percentage (> 12%) of natural killer (NK) cells in patients with pregnancy complications (60% vs. 12%, P < 0.05). Our retrospective data shows an improvement of late pregnancy complications by additional use of IVIG. It is possible that IVIG influences higher NK cell activity in patients with previous pregnancy complications.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1055/s-0029-1145261

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • IVIG was not associated with a higher proportion of live births compared with conventional treatment in three small observational studies, though confounding by indication may have occurred.

    “Use of IVIG was not associated with a higher proportion of live births compared with conventional treatment in three small observational studies58–60 that directly addressed this question, although confounding by indication may have occurred.”

    From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [60]

    The Abstract reports a higher observed proportion of live births with added IVIG than with standard therapy (83.7% versus 74.3%), contrary to the claim as worded. The Patients section supports the concern about confounding by indication: IVIG was given to women whose standard treatment had failed. The paper does not establish whether the live-birth difference was statistically significant. (LLM, conf=0.78)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 56 · Cited by 35

Research works printed but not linked: 30

  1. Cervera R, Piette JC, Font J, Khamashta MA; for the Euro- Phospholipid project group. Antiphospholipid syndrome. Arthritis Rheum 2002;46:1019-1027
  2. Katano K, Aoki A, Sasa H, et al. b 2-glykoprotein1- dependent anticardiolipin antibodies as a predictor of adverse pregnancy outcomes in healthy pregnant women. Hum Reprod 1996;11:509-512
  3. Pattison NS, Chamley LW, McKay EJ, et al. Antiphospho- lipid-antibodies in pregnancy: prevalence and clinical associ- ation. Br J Obstet Gynaecol 1993;100:909-913
  4. Vashisht A, Regan L. Antiphospholipid syndrome in pregnancy-an update. J R Coll Physicians (Edinburg) 2005; 35:337-339
  5. Bates SM, Greer IA, Hirsh J, Ginsberg JS. Use of antithrombotic agents during pregnancy: the Seventh ACCP Conference on antithrombotic and thrombolytic therapy. Chest 2004;127(suppl 3):627-644
  6. Stephenson MD, Ballem PJ, Tsang P, et al. Treatment of antiphospholipid antibody syndrome (APS) in pregnancy: a randomized pilot trial comparing low molecular heparin to unfractionated heparin. J Obstet Gynaecol Canada 2004;26: 729-734
  7. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 1995;74:1185-1190
  8. Lim W, Crowther MA, Eikelboom JW. Management of antiphospholipid antibody syndrome: a systematic review. JAMA 2006;295:1050-1057
  9. Tincani A, Bazzani C, Zingarelli S, Lojacono A. Lupus and the antiphopsholipid syndrome in pregnancy and obstectrics: clinical characteristics, diagnosis, pathogenesis and treatment. Semin Thromb Hemost 2008;34:267-273
  10. Tincani A, Branch W, Levy RA, et al. Treatment of patients with antiphospholipid syndrome. Lupus 2003;12:524-529
  11. Carp HJA, Asherson RA, Shoenfeld Y. Intravenous immunglobulin in pregnancies complicated by the antiphos- pholipid syndrome: what is its role. J Clin Rheumatol 2001; 7:291-294
  12. Perricone C, Carolis CD, Giacomelli R, et al. High levels of NK cells in the peripheral blood of patients affected with antiphospholipid syndrome and recurrent spontaneous abor- tion: a potential new hypothesis. Rheumatology 2007;46: 1574-1578
  13. Emmer PM, Nelen WLDM, Steegers EAP, Hendriks JCM, Veerkoek M, Joosten I. Peripheral natural killer cell cytotoxicity and CD56pos CD16 pos cells increase during early pregnancy in women with a history of recurrent spontaneous abortion. Hum Reprod 2000;15:1163-1169
  14. Van den Heuvel MJ, Crystal GP, Hatta K, Han VK, Clark DA. Decline in number of elevated blood CD3þ CD56þ NKT cells in response to intravenous immunoglobulin treatment correlates with successful pregnancy. Am J Reprod Immunol 2007;58:447-459
  15. Beer AE, Kwaak TY, Ruiz JE. Immunophenotypic profiles of peripheral blood lymphocytes in women with recurrent pregnancy loss and infertile women with multiple failed in vitro fertilization cycles. Am J Reprod Immunol 1996;35: 376-382
  16. Coulam CB, Beaman KD. Reciprocal alteration in circulating TJ6þ CD19þ and TJ6þ CD56þ leukocytes in early pregnancy predict success or miscarriage. Am J Reprod Immunol 1995;34:219-224
  17. Kwak-Kim J, Gillman-Sachs A. Clinical implication of natural killer cells and reproduction. Am J Reprod Immunol 2008;59:388-400
  18. Keskin DB, David S, Allan J, et al. TGFß promotes conversion of CD16þ peripheral blood NK cells into CD16-NK cells with similarities to decidual NK cells. Proc Natl Acad Sci U S A 2007;104:3378-3383
  19. Yamada H, Shimada S, Morikawa M, et al. Divergence of natural killer cell receptor and related molecule in the decidua from sporatic miscarriage with normal chromosome karyo- type. Mol Hum Reprod 2005;11:451-457
  20. Hiby SE, Regan L, Lo W, Farrell L, Carrington M, Moffet A. Association of maternal killer-cell immunoglobulin-like receptor and parental HLA-C genotypes with recurrent miscarriage. Hum Reprod 2008;23:972-976
  21. Lockshin MD, Sammaritano LR, Schwartzman S. Valida- tion of the Sapporo criteria for antiphospholipid syndrome. Arthritis Rheum 2000;43:440-443
  22. Carmo-Pereira S, Bertolaccini ML, Escudero-Contres A, et al. Value of IgA anticardiolipin and anti-B-2 glycoprotein 1 antibody testing in patients with pregnancy morbidity. Ann Rheum Dis 2003;62:540-543
  23. Chong P, Matzner W, Ching W. Correlation between beta- 2-glycoprotein antibodies and antiphospholipid antibodies in patients with reproductive failure. Am J Reprod Immunol 1998;40:414-417
  24. Stojanovich L, Mikovic Z, Mandic V, Popvid-Kuzmanovic D. Treatment of antiphospholipid-syndrome in pregnancy with low dose of intravenous immunoglobulin. Isr Med Assoc J 2007;9:555-556
  25. Lynch A, Mariar R, Murphy J, et al. Antiphospholipid antibodies in predicting adverse pregnancy outcome. Ann Intern Med 1994;120:470-475
  26. Kaira S, Tuli A, Goyal U, Choudhary R, Raheja S. Correlation of antiphospholipid antibody IgM with first trimester recurrent abortion. J Anat Soc India 2002;51: 10-13
  27. Lockwood CJ, Omero R, Feinburg RF, Clyne LP, Coster B, Hobbins JC. The prevalence and biologic significance of lupus anticoagulant and anticardiolipin antibodies in a general population. Am J Obstet Gynecol 1989;161:369-373
  28. Branch DW, Peacman AM, Druzin M. A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphospholipid syndrome during pregnancy. The pregnancy loss study group. Am J Obstet Gynecol 2000;182:122-127
  29. Sargent IL, Borzychowski AM, Redman CWG. NK cells and preeclampsia. J Reprod Immunol 2007;76:40-44
  30. Radder CM, Roelen DL, van de Meer-Prind EM, et al. The immunologic profile of infants born after maternal immuno- globulin treatment and intrauterine platelet transfusion for fetal/alloimmune thrombozytopenia. Am J Obstet Gynecol 2004;191:815-820

Authors
Heilmann, L., Schorch, M., Hahn, T., Adasz, G., Schilberz, K., Adiguzel, C., & Fareed, J.
Affiliations
Loyola University Medical Center (US)
ORCID
Fareed, Jawed
Venue
Seminars in Thrombosis and Hemostasis
Publisher
Georg Thieme Verlag KG
Published
2008-11
Volume
34
Issue
08
Pages
794-802
ISSN
  • 0094-6176 (ISSN-L)
  • 1098-9064
DOI
10.1055/s-0029-1145261
OpenAlex
W2091568042
Cited by
35
References
56
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 3 · 2017: 2 · 2016: 3 · 2015: 4 · 2013: 1 · 2012: 2
FWCI
1.84
Type
journal article
Language
en
Open access
Locations
  • Seminars in Thrombosis and Hemostasis (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords
antiphospholipid syndrome, pregnancy outcomes, intravenous immunoglobulin, low molecular weight heparin, aspirin, live birth rate, abortion, late pregnancy complications, natural killer cells, pregnancy complications
MeSH terms
Anticoagulants, Aspirin, Female, Heparin, Low-Molecular-Weight, Humans, Killer Cells, Natural, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Retrospective Studies, Antiphospholipid Syndrome, Immunoglobulins, Intravenous, Treatment Outcome, Antibodies, Antiphospholipid

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review