Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity: A European multicentre retrospective study

Amelia Ruffatti, Elisa Salvan, Teresa Del Ross, Maria Gerosa, Laura Andreoli, Aldo Maina, Jaume Alijotas-Reig, Sara De Carolis, Arsene Mekinian, Maria Tiziana Bertero, Valentina Canti, Antonio Brucato, Katarina Bremme, Véronique Ramoni, Marta Mosca, Emma Di Poi, Paola Caramaschi, Mauro Galeazzi, Angela Tincani, Pier Luigi Meroni

Research output: Contribution to journalArticlepeer-review

Abstract

Previous thrombosis, diagnosis of systemic lupus erythematosus (SLE) and triple antiphospholipid (aPL) antibody positivity have recently been found to be independent factors associated to pregnancy failure during conventional therapy in women with antiphospholipid syndrome (APS). This study aimed to assess the effect of various treatment strategies on pregnancy outcomes in women with APS and the risk factors for pregnancy failure. One hundred ninety-six pregnancies of 156 patients diagnosed with APS were analysed: 118 (60.2%) of these had previous thrombosis, 81 (41.3%) were diagnosed with SLE, and 107 (54.6%) had triple aPL positivity. One hundred seventy-five (89.3%) were treated with conventional therapies (low-dose aspirin [LDA] or prophylactic doses of heparin + LDA or therapeutic doses of heparin + LDA), while 21 (10.7%) were prescribed other treatments in addition to conventional therapy. The pregnancies were classified into seven risk profiles depending on the patients’ risk factors – thrombosis, SLE, and triple aPL positivity – and their single, double or triple combinations. It was possible to find significant difference in outcomes correlated to treatments only in the thrombosis plus triple aPL positivity subset, and logistic regression analysis showed that additional treatments were the only independent factor associated to a favourable pregnancy outcome (odds ratio=9.7, 95% confidence interval= 1.1–88.9, p-value

Original languageEnglish
Pages (from-to)727-735
Number of pages9
JournalThrombosis and Haemostasis
Volume112
Issue number4
DOIs
Publication statusPublished - 2014

Keywords

  • Antiphospholipid antibodies
  • Antiphospholipid syndrome
  • Pregnancy
  • Risk factors
  • Treatment

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

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