The impact of various entities of antiphospholipid antibodies positivity on adverse pregnancy outcome. An epidemiological perspective
| Autor: | Fausta Beneventi, Camilla Bellingeri, Carlomaurizio Montecucco, Irene De Maggio, Claudia Alpini, Greta Riceputi, Carolina Spada, Maria Paola Pandolfi, Arsenio Spinillo |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Immunology Logistic regression Asymptomatic 03 medical and health sciences 0302 clinical medicine Cost of Illness Pregnancy Risk Factors Antiphospholipid syndrome Internal medicine Epidemiology Humans Immunology and Allergy Medicine 030219 obstetrics & reproductive medicine biology business.industry Incidence Pregnancy Outcome Obstetrics and Gynecology Antiphospholipid Syndrome medicine.disease Pregnancy Complications 030104 developmental biology Increased risk Reproductive Medicine Case-Control Studies Asymptomatic Diseases Attributable risk Antibodies Antiphospholipid biology.protein Female Antibody medicine.symptom business |
| Zdroj: | Journal of Reproductive Immunology. 145:103304 |
| ISSN: | 0165-0378 2013-2018 |
| Popis: | The aim of the study was to evaluate the rate of obstetric complications and the burden of obstetric outcomes in antiphospholipid syndrome (APS), non-criteria APS and asymptomatic antiphospholipid antibodies (aPL) carriers. From 2013-2018, 163 pregnant subjects with aPL antibodies and 785 controls were enrolled. Penalized logistic regression was used to compare obstetric complications. Cases included 62 complete APS (38 %), 48 non-criteria APS (29.4 %) and 53 (32.5 %) asymptomatic aPL-carriers. Connective tissue diseases (CTDs) were diagnosed in 31.3 % of cases. The rate of high-risk aPL profile was higher (p < .01) in APS (67.7 %) compared to non-criteria (14.6 %) and aPL-carriers (9.4 %). Double/triple positivity was 33.9 % (p < .05 compared to non-criteria and aPL-carriers) in APS, 10.4 % in non-criteria and 9.4 % in aPL-carriers. The rate of adverse pregnancy outcomes were 5.6 % in controls, 41.9 % (adj.OR = 6.95 %CI = 2.7-13.5) in APS, 25 % (adj.OR = 4.4,95 %CI = 2-9.4) in non-criteria and 28.3 % (OR = 4.95 %CI = 1.8-8.8) in aPL-carriers. CTDs were independently associated with an increased risk of adverse obstetric outcomes (OR = 2.8,95 %CI = 1.36-5.89). The attributable fraction (AF) of adverse obstetric events was higher among low-risk antibodies compared to high-risk (AF = 0.27,95 %CI = 0.22-0.31 vs AF = 0.16,95 %CI = 0.16-0.2,p < .01) and among single positivity compared to double/triple positivity (AF = 0.32,95 %CI = 0.26-0.37 vs AF = 0.11,95 %CI = 0.09-0.13,p < .01) suggesting that low-risk subjects are responsible for a high burden of obstetric complications. |
| Databáze: | OpenAIRE |
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