Antiphospholid antibodies and the risk of pregnancy complications

Abstract

Antiphospholipid antibodies (APLAbs) are generally considered as risk factors for foetal death, for premature birth ≤ 34 weeks due to severe pre-eclampsia or severe placental insufficiency and for recurrent consecutive spontaneous abortions < 10 weeks. Among these three obstetrical morbidities, only the first one is however not regularly questioned. The coexistence of an inflammatory disease and/or of thrombotic manifestations increases the obstetrical risks. Among the three criteria APLAbs, i.e. lupus anticoagulant (LA), anticardiolipin (aCL) Abs, anti-β2 glycoprotein-I (aβ2GP1)Abs, LA seems the more widely associated to clinical risks, the clinical impact of aβ2GP1Abs is progressively defined and the pejorative impact of triple positivity is still discussed. High quality prospective multicentric epidemiological studies are still awaited. The identification of predictors of pregnancy outcome is necessary to streamline the design and use of new treatments acting on pathophysiological molecular targets.