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Inicio Medicina Clínica (English Edition) Comparative study between obstetric antiphospholipid syndrome and obstetric morb...
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Vol. 151. Issue 6.
Pages 215-222 (September 2018)
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Vol. 151. Issue 6.
Pages 215-222 (September 2018)
Original article
Comparative study between obstetric antiphospholipid syndrome and obstetric morbidity related with antiphospholipid antibodies
Estudio comparativo entre síndrome antifisfolipídico obstèc)trico y morbilidad obstèc)trica relacionada con anticuerpos antifosfolípido
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Jaume Alijotas-Reiga,
Corresponding author
, Enrique Esteve-Valverdeb, Raquel Ferrer-Oliverasc,
Corresponding author
raquelfo22@hotmail.com

Corresponding author.
, Elisa LLurbad, Amelia Ruffattie, Angela Tincanif, Elmina Lefkoug, Mª Tiziana Berteroh, Gerard Espinosai, Sara de Carolisj, Patrizia Rovere-Querinik, Krista Lundelinl, Elisa Picardom, Arsene Mekiniann, for the EUROAPS Study Group
a Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d
tm)Hebron University Hospital, Department of Medicine, Universitat Autonoma, Barcelona, Spain
b Internal Medicine Department, Althaia Healthcare Network of Manresa, Rheumatology Unit, Barcelona, Spain
c Obstetrics and Gynaecology Department, High Risk Unit, Vall d
tm)Hebron University Hospital, Universitat Autonoma, Barcelona, Spain
d Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
e Rheumatology Unit, Department of Clinical and Experimental Medicine Azienda Ospedaliera, University of Padua, Padua, Italy
f Rheumatology and Clinical Immunology Unit, Ospedale Civile, Brescia, Italy
g Haematology Unit, Hippokration Hospital of Thessaloniki, Greece
h Department of Clinical Immunology, A.O. Mauriziano-Umberto I, Turin, Italy
i Systemic Autoimmune Diseases Service, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
j Department of Gynaecology, Gemmeli Hospital, Catholic University, Roma, Italy
k 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
l Internal Medicine Department, Hospital Universitario La Paz, Universidad Autònoma, Madrid, Spain
m Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy
n AP-HP, Hôpital Saint-Antoine, service de mèc)decine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universitèc)s, UPMC Univ Paris 06, F-75012, Paris, France
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Figures (1)
Tables (5)
Table 1. Demographic characteristics and main general data of two groups.
Table 2. Comparative laboratory results between OAPS and OMAPS groups.a
Table 3. Current pregnancy obstetrical complications in OAPS and OMAPS groups.
Table 4. Live births and treatment in OAPS and OMAPS group.
Table 5. Treatment comparison between OAPS and OMAPS groups.
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Additional material (1)
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.

Keywords:
Antiphospholipid antibody
Antiphospholipid syndrome
Obstetric morbidity, Incomplete obstetric antiphospholipid syndrome
Registry
Resumen
Fundamento Y objetivos

Comparar características clínicas, analíticas, tratamiento y tasa de hijos vivos entre gestantes con Síndrome Antifosfolípido Obstèc)trico (SAFO) y gestantes con morbilidad obstèc)trica relacionada con el síndrome que no cumplen los criterios de clasificación actuales.

Material Y mèc)todos

Estudio observacional retrospectivo y prospectivo multicèc)ntrico: datos de once hospitales terciarios europeos recogidos en el European Registry on Antiphospholipid Syndrome.

Resultados

Se analizaron 338 mujeres: 247 cumplían criterios de Sydney para SAFO (grupo OAPS), y 91 no (grupo OMAPS). En el grupo OMAPS, 24/91(26.37%) cumplían criterios analíticos, pero no clínicos para SAFO (subgrupo A) y 67/91(74.63%) presentaban títulos medio-bajos o títulos positivos no persistentes de anticuerpos antifosfolípido, con o sin cumplir criterios clínicos (subgrupo B). Se observaron diferencias significativas entre los 2 grupos en cuanto a las categorías analíticas: 34% vs. 11% (p<0.0001) para la categoría I y 66% vs. 89% (p<0.0001) para la categoría II, OAPS vs OMAPS, respectivamente. No se observaron diferencias significativas en cuanto a las complicaciones obstèc)tricas (p=0.481). El 86.20% del grupo OAPS recibió tratamiento vs.el 75.82% del grupo OMAPS (p=0.0224). No se observaron diferencias en la tasa de hijos vivos, ni en la tasa de trombosis arterial y/o venosa gestacional y/o puerperal.

Conclusiones

Ambos grupos fueron muy homogèc)neos, excepto en cuanto a la distribución de las categorías analíticas y en la tasa de tratamiento. Ambos grupos mostraron buenos resultados al ser tratados. Los resultados respaldan la opinión de muchos expertos de tener que revisar los criterios de clasificación actuales del Síndrome Antifosfolípido Obstèc)trico.

Palabras clave:
Anticuerpos antifosfolípido
Síndrome antifosfolípido
Morbilidad obstèc)trica
Síndrome antifosfolípido obstèc)trico incompleto
Registro

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