Recurrent abortion and moderate or strong antiphospholipid antibody production

• Published in: International journal of gynecology and obstetrics 1998-08, Vol.62 (2), p.183-188
• Main Authors: Ogasawara, M, Sasa, H, Katano, K, Aoyama, T, Aoki, K, Suzumori, K
• Format: Article
• Language: English
• Subjects: Abortion, Habitual - immunology; Abortion, Habitual - prevention & control; Adult; Anti-Inflammatory Agents - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Antibodies, Antiphospholipid - biosynthesis; anticardiolipin antibody (aCL); Antiphospholipid antibodies; antiphospholipid antibody (aPL); aspirin (ASA); Aspirin - therapeutic use; beta 2-Glycoprotein I; Biological and medical sciences; cardiolipin (CL); Diseases of mother, fetus and pregnancy; Drug Therapy, Combination; enzyme‐linked immunosorbent assay (ELISA); Female; Glycoproteins - analysis; Gynecology. Andrology. Obstetrics; Humans; immunoglobulin (IgG); Immunoglobulin G - therapeutic use; Lupus anticoagulant; lupus anticoagulant (LA); Medical sciences; phosphatidyl ethanolamine (PE); predninine (PSL); Prednisolone - therapeutic use; Pregnancy; Pregnancy Complications - prevention & control; Pregnancy Outcome; Pregnancy, High-Risk - immunology; Pregnancy. Fetus. Placenta; Recurrent miscarriage; standard deviation (S.D.); Treatment procedures; β 2-glycoprotein I dependent anticardiolipin antibodies; β2‐glycoprotein I (β2GPI); β2‐glycoprotein I dependent anticardiolipin antibodies
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/S0020-7292(98)00099-X

Objective: To investigate the treatment outcome for women suffering recurrent miscarriages associated with strong or moderate antiphospholipid antibody (aPL) production. Methods: Sixty-seven pregnancies in 61 women demonstrating at least one kind of aPL with a history of recurrent miscarriages were treated with: (1) aspirin (ASA) alone; (2) prednisolone (PSL) and ASA; and (3) PSL, ASA, heparin and/or immunoglobulin (IgG). For comparison purposes the aPL-positive patients were divided into two groups, strongly and moderately-positive. IgG and IgM antibodies against PE and five negatively-charged phospholipids were measured by ELISA between 1987 and 1993. β 2-glycoprotein I (β 2GPI) dependent anticardiolipin antibodies were measured by ELISA since 1993. Lupus anticoagulant was measured by a diluted aPTT method since 1993. Results: Out of a total of 16 (50%) patients strongly-positive for aPL and 47 out of 51 (92.2%) moderately-positive demonstrated a successful outcome. The live birth rate moderate group was significantly higher than in the strongly-positive cases ( P