The association between antiphospholipid antibodies and pregnancy morbidity, stroke, myocardial infarction, and deep vein thrombosis: a critical review of the literature

In a previous systematic literature search, we demonstrated that the frequencies of antiphospholipid antibodies (aPL) in general-population patients with pregnancy morbidity (PM), deep vein thrombosis (DVT), myocardial infarction (MI), and stroke (ST) are 6%, 10%, 11%, and 14%. To determine the asso...

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Bibliographic Details
Published in:Lupus 2015-08, Vol.24 (9), p.980-984
Main Authors: Chighizola, C B, Andreoli, L, de Jesus, G Ramires, Banzato, A, Pons-Estel, G J, Erkan, D
Format: Article
Language:English
Subjects:
Abortion, Spontaneous - immunology
Antibodies
Antibodies, Antiphospholipid - immunology
Antiphospholipid Syndrome - immunology
Chi-square test
Clinical outcomes
Eclampsia
Female
Fetal Growth Retardation - immunology
Heart attacks
Humans
Literature reviews
Lupus
Lupus Coagulation Inhibitor
Morbidity
Myocardial Infarction - immunology
Pre-Eclampsia - immunology
Preeclampsia
Pregnancy
Pregnancy Complications - immunology
Pregnancy Outcome
Stroke
Stroke - immunology
Thrombosis
Venous Thrombosis - immunology
Womens health
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Summary:In a previous systematic literature search, we demonstrated that the frequencies of antiphospholipid antibodies (aPL) in general-population patients with pregnancy morbidity (PM), deep vein thrombosis (DVT), myocardial infarction (MI), and stroke (ST) are 6%, 10%, 11%, and 14%. To determine the association between aPL and clinical outcomes, we conducted a follow-up analysis of the 120 studies included in the original paper. Based on the analysis of 81 studies, a significant difference in the frequency of aPL criteria tests between patients and controls emerged considering all the outcomes together (10% versus 3%). In particular, a significant difference was reported for overall PM, pregnancy loss (PrL), late PrL, severe preeclampsia (PEC), ST, MI, and DVT. No difference emerged for early PrL, intrauterine growth restriction (IUGR), PEC, eclampsia (EC), and HELLP. A positive association was found in more than half of the studies for overall PrL, severe PEC, HELLP, ST, MI, and DVT and in less than half for early and late PrL, PEC, EC, and IUGR. The positive association between aPL and clinical outcomes included in the antiphospholipid syndrome classification criteria is not supported by every study, being particularly inconsistent for early PL, IUGR, PEC, EC, and HELLP.
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203315572714