Comparative study between obstetric antiphospholipid syndrome and obstetric morbidity related with antiphospholipid antibodies.

Autor:	Alijotas-Reig J; Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autonoma, Barcelona, Spain. Electronic address: jalijotas@vhebron.net., Esteve-Valverde E; Internal Medicine Department, Althaia Healthcare Network of Manresa, Rheumatology Unit, Barcelona, Spain., Ferrer-Oliveras R; Obstetrics and Gynaecology Department, High Risk Unit, Vall d'Hebron University Hospital, Universitat Autonoma, Barcelona, Spain. Electronic address: raquelfo22@hotmail.com., LLurba E; Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Ruffatti A; Rheumatology Unit, Department of Clinical and Experimental Medicine Azienda Ospedaliera, University of Padua, Padua, Italy., Tincani A; Rheumatology and Clinical Immunology Unit, Ospedale Civile, Brescia, Italy., Lefkou E; Haematology Unit, Hippokration Hospital of Thessaloniki, Greece., Bertero MT; Department of Clinical Immunology, A.O. Mauriziano-Umberto I, Turin, Italy., Espinosa G; Systemic Autoimmune Diseases Service, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain., de Carolis S; Department of Gynaecology, Gemmeli Hospital, Catholic University, Roma, Italy., Rovere-Querini P; 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., Lundelin K; Internal Medicine Department, Hospital Universitario La Paz, Universidad Autònoma, Madrid, Spain., Picardo E; Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy., Mekinian A; 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.
Jazyk:	English; Spanish; Castilian
Zdroj:	Medicina clinica [Med Clin (Barc)] 2018 Sep 21; Vol. 151 (6), pp. 215-222. Date of Electronic Publication: 2017 Dec 20.
DOI:	10.1016/j.medcli.2017.11.017
Abstrakt:	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. (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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