Pregnancy outcome in different clinical phenotypes of antiphospholipid syndrome
Abstract
Women with antiphospholipid syndrome (APS) may have diverse pregnancy outcomes. The objective of this study was to evaluate pregnancy outcome in women with APS according to their clinical phenotype, i.e. thrombotic and obstetric APS. Eighty-three pregnancies in 67 women with APS were included in the study, including 21 with recurrent miscarriage (Group 1), 21 with late fetal loss or early delivery due to placental dysfunction (Group 2) and 41 with thrombotic APS (Group 3). Group 3 had higher rates of preterm delivery (26.8% versus 4.7%, p = 0.05) than Group 1 and more small for gestational age (SGA) babies than Group 2 (39.5% versus 4.8%, p = 0.003). Group 2 had significantly longer gestations compared with their pretreatment pregnancies (38.4 [28.4-41.4] versus 24.0 [18-35] weeks, p < 0.0001) and 100% live birth rate after treatment with aspirin and low-molecular-weight heparin (LMWH). In conclusion, women with thrombotic APS (Group 3) have higher rates of pregnancy complications than those with obstetric APS (Groups 1 and 2). Treatment with aspirin and LMWH is associated with improved outcomes for women with previous late fetal loss or early delivery due to placental dysfunction (Group 2).
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In observational studies, LDA plus therapeutic dose heparin was associated with live births in 79% of pregnancies on average.
“In observational studies, treatment with LDA and therapeutic dose heparin was associated with live births in 79% of pregnancies on average.52 61–64”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [62]
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- Authors
- Bramham, K., Hunt, B., Germain, S., Calatayud, I., Khamashta, M., Bewley, S., & Nelson-Piercy, C.
- Affiliations
- Guy's Hospital (GB)
- Department of Maternal Medicine, Women's services directorate and Lupus Unit, Guy's & St Thomas' NHS Foundation Trust, London, UK
- Department of Maternal Medicine, Women's services directorate and Lupus Unit, Guy's & St Thomas' NHS Foundation Trust, London, UK,
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2009-11-06
- Volume
- 19
- Issue
- 1
- Pages
- 58-64
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- OpenAlex
- W2043383287
- Cited by
- 185
- References
- 40
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 5 · 2022: 4 · 2021: 14 · 2020: 9 · 2019: 12 · 2018: 15 · 2017: 11 · 2016: 13 · 2015: 12 · 2014: 17 · 2013: 13 · 2012: 15
- FWCI
- 9.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lupus (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (DRF-2009-02-18)
- 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, clinical phenotype, thrombotic antiphospholipid syndrome, obstetric antiphospholipid syndrome, recurrent pregnancy loss, placental insufficiency, preterm birth, small for gestational age, aspirin, low molecular weight heparin
- MeSH terms
- Adult, Aspirin, Female, Heparin, Low-Molecular-Weight, Humans, Infant, Newborn, Infant, Small for Gestational Age, Obstetric Labor, Premature, Phenotype, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Retrospective Studies, Antiphospholipid Syndrome
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