BACKGROUND: The association between antiphospholipid antibodies (APLA) and placenta mediated pregnancy complications (pre-eclampsia, intrauterine growth restriction (IUGR), late fetal loss and placental abruption) remains controversial. METHODS: We performed a systematic review of published case-control, cohort and cross sectional studies (MEDLINE (1975 to 2009), EMBASE 16 (1980 to 2009) and all EBM Reviews (2009)) to evaluate the association between APLA and placenta mediated complications in untreated women without autoimmune diseases. RESULTS: Our search strategy identified 1207 potentially relevant studies. Twenty eight were included in the final analysis. LA was associated with pre-eclampsia (OR 2.34; 95% CI 1.18-4.64), IUGR (OR 4.65 95% CI 1.29-16.71) and late fetal loss (OR 4.73; 95% CI 1.08-20.81) amongst case-control studies and only with late fetal loss (OR 10.59 95% CI 1.87-59.88) amongst cohort studies. ACA were associated with pre-eclampsia (OR 1.52; 95% CI 1.05-2.20) and late fetal loss (OR 4.29; 95% CI 1.34-13.68) amongst case-control studies and only late fetal loss (OR 8.85 95% CI 1.84-42.50) amongst cohort studies. Finally, anti-B2 GP1 antibodies showed associations with pre-eclampsia (OR 19.14, 95% CI 6.34-57.77), IUGR (OR 20.03; 95% CI 4.59-87.43) and late fetal loss (OR 23.46, 95% CI 1.21-455.01) in two cohort studies. CONCLUSION: APLAs appear to be associated with late fetal losses. However, the association between APLAs and other placenta mediated complications is inconsistent. LA is most strongly and consistently associated with placenta mediated complications. There are currently insufficient data to support a significant link between anti-B2 GP1 antibodies and pregnancy morbidity.
BACKGROUND: The association between antiphospholipid antibodies (APLA) and placenta mediated pregnancy complications (pre-eclampsia, intrauterine growth restriction (IUGR), late fetal loss and placental abruption) remains controversial. METHODS: We performed a systematic review of published case-control, cohort and cross sectional studies (MEDLINE (1975 to 2009), EMBASE 16 (1980 to 2009) and all EBM Reviews (2009)) to evaluate the association between APLA and placenta mediated complications in untreated women without autoimmune diseases. RESULTS: Our search strategy identified 1207 potentially relevant studies. Twenty eight were included in the final analysis. LA was associated with pre-eclampsia (OR 2.34; 95% CI 1.18-4.64), IUGR (OR 4.65 95% CI 1.29-16.71) and late fetal loss (OR 4.73; 95% CI 1.08-20.81) amongst case-control studies and only with late fetal loss (OR 10.59 95% CI 1.87-59.88) amongst cohort studies. ACA were associated with pre-eclampsia (OR 1.52; 95% CI 1.05-2.20) and late fetal loss (OR 4.29; 95% CI 1.34-13.68) amongst case-control studies and only late fetal loss (OR 8.85 95% CI 1.84-42.50) amongst cohort studies. Finally, anti-B2 GP1 antibodies showed associations with pre-eclampsia (OR 19.14, 95% CI 6.34-57.77), IUGR (OR 20.03; 95% CI 4.59-87.43) and late fetal loss (OR 23.46, 95% CI 1.21-455.01) in two cohort studies. CONCLUSION: APLAs appear to be associated with late fetal losses. However, the association between APLAs and other placenta mediated complications is inconsistent. LA is most strongly and consistently associated with placenta mediated complications. There are currently insufficient data to support a significant link between anti-B2 GP1 antibodies and pregnancy morbidity.
Authors: K J Gibbins; S L Mumford; L A Sjaarda; D W Branch; N J Perkins; A Ye; E F Schisterman; R M Silver Journal: Lupus Date: 2018-05-17 Impact factor: 2.911
Authors: John Allotey; Kym Ie Snell; Melanie Smuk; Richard Hooper; Claire L Chan; Asif Ahmed; Lucy C Chappell; Peter von Dadelszen; Julie Dodds; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon Cs Smith; Wessel Ganzevoort; Hannele Laivuori; Anthony O Odibo; Javier A Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc Jm Smits; Christina A Vinter; Per M Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; SeonAe Yeo; Helena J Teede; Joyce L Browne; Karel Gm Moons; Richard D Riley; Shakila Thangaratinam Journal: Health Technol Assess Date: 2020-12 Impact factor: 4.014
Authors: Kathleen A Pennington; Jessica M Schlitt; Daniel L Jackson; Laura C Schulz; Danny J Schust Journal: Dis Model Mech Date: 2012-01 Impact factor: 5.758