Antiphospholipid antibodies in pregnancy: prevalence and clinical associations

Abstract

Objective To determine prevalence, clinical association and predictive power of antiphospholipid antibodies in pregnancy. Design To test for the presence of anticardiolipin antibodies and lupus anticoagulant in order to confirm prevalence data which imply that each antibody has the same clinical significance. A detailed obstetric history and the outcome measures were obtained from each patient in the study. Setting National Women's Hospital, Auckland, New Zealand. Subjects Nine hundred and thirty-three consecutively booked pregnant women. Main outcome measures Prevalence of auto-antibodies; perinatal morbidity and mortality; incidence of preeclampsia, growth retardation and fetal distress. Results Nine women (1.0%) had anticardiolipin antibodies, 11 (1.2%) had lupus anticoagulant and two had both antibodies. The fetal mortality rate for women with antibodies was 167/1000. Pre-eclampsia occurred significantly more often in women with auto-antibodies. Conclusion The presence of antiphospholipid antibodies is frequently associated with adverse pregnancy outcome (9/18 pregnancies). High titre anticardiolipin antibodies carry a poor prognosis.