62: Obstetric outcomes in pregnant women with primary antiphospholipid syndrome according to the antibody profile: The PREGNANTS study

Introduction: Previous studies suggested different obstetric outcomes between patients with thrombotic or obstetric antiphospholipid syndrome, but the data are inconclusive. Aims: To investigate obstetric outcomes and their relation to the antiphospholipid antibody profile in primary thrombotic or obstetric antiphospholipid syndrome patients and compare those to a control population. Materials and methods: A retrospective single-centre study on a cohort of 30 pregnant women with primary antiphospholipid syndrome treated at Karolinska University Hospital Solna, Sweden between 2000 and 2016. The pregnancy outcomes were compared to the outcomes of all pregnancies in Stockholm County during the same period. Results: Preeclampsia ( p < 0.001), low birth weight at delivery ( p = 0.001), Apgar < 7 at 5 minutes ( p < 0.001) and small infants ( p < 0.001) were more common in antiphospholipid syndrome patients compared to controls. Obstetric antiphospholipid syndrome patients had a higher incidence of small infants ( p = 0.023), lower birth weight ( p = 0.013) and infants born with complications ( p=0.004) compared to thrombotic antiphospholipid syndrome. Mothers with triple antibody positivity had a higher incidence of preeclampsia ( p = 0.03), preterm delivery ( p = 0.011), small infants ( p=0.002) and infants born with complications ( p = 0.012). Conclusions: Patients with primary antiphospholipid syndrome, especially those with obstetric antiphospholipid syndrome and triple antibody positivity, are at higher risk for adverse pregnancy outcomes, even under antithrombotic treatment. More frequent antenatal controls in high-risk patients can further improve outcomes.

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The impact of antibody profile in thrombosis associated with primary antiphospholipid syndrome

American Journal of Hematology ◽

10.1002/ajh.24875 ◽

2017 ◽

Vol 92 (11) ◽

pp. 1163-1169 ◽

Cited By ~ 5

Author(s):

Sabrina da Silva Saraiva ◽

Bruna de Moraes Mazetto ◽

Lais Quinteiro Tobaldine ◽

Marina Pereira Colella ◽

Erich Vinícius De Paula ◽

...

Keyword(s):

Antiphospholipid Syndrome ◽

Primary Antiphospholipid Syndrome ◽

Antibody Profile ◽

The Impact

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73 Timing of prophylaxis with aspirin and low molecular weight heparin in pregnant women with primary antiphospholipid syndrome and recurrent miscarriages

Thrombosis Research ◽

10.1016/s0049-3848(07)70118-4 ◽

2007 ◽

Vol 119 ◽

pp. S117

Author(s):

T. Hatzis ◽

H. Mantouvalos

Keyword(s):

Molecular Weight ◽

Pregnant Women ◽

Antiphospholipid Syndrome ◽

Low Molecular Weight Heparin ◽

Low Molecular Weight ◽

Primary Antiphospholipid Syndrome ◽

Recurrent Miscarriages

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Distinct antibody profile: a clue to primary antiphospholipid syndrome evolving into systemic lupus erythematosus?

Clinical Rheumatology ◽

10.1007/s10067-013-2472-3 ◽

2014 ◽

Vol 33 (3) ◽

pp. 349-353 ◽

Cited By ~ 11

Author(s):

Paula Vieira Freire ◽

Elisa Watanabe ◽

Nelita Rocha dos Santos ◽

Cleonice Bueno ◽

Eloísa Bonfá ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Antiphospholipid Syndrome ◽

Lupus Erythematosus ◽

Primary Antiphospholipid Syndrome ◽

Systemic Lupus ◽

Antibody Profile

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THU0343 Recurrent Thrombosis in Young Patients with Primary Antiphospholipid Syndrome: The Relevance of The Antiphospholipid Antibody Profile

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.3397 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 311.1-311

Author(s):

M. Rodrigues ◽

C. Nalli ◽

L. Andreoli ◽

E. Balestreri ◽

A. Zanola ◽

...

Keyword(s):

Antiphospholipid Syndrome ◽

Young Patients ◽

Antiphospholipid Antibody ◽

Primary Antiphospholipid Syndrome ◽

Recurrent Thrombosis ◽

Antibody Profile

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ANTIPHOSPHATIDYLSERINE/PROTHROMBIN ANTIBODIES AS A RISK FACTOR OF DISEASE SEVERITY IN PRIMARY ANTIPHOSPHOLIPID SYNDROME

10.26226/morressier.56e174cfd462b8028d88a378 ◽

2016 ◽

Author(s):

Ariela Hoxha

Keyword(s):

Risk Factor ◽

Disease Severity ◽

Antiphospholipid Syndrome ◽

Primary Antiphospholipid Syndrome

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Pregnant Women Living with Obesity: A Cross-Sectional Observational Study of Dietary Quality and Pregnancy Outcomes

Nutrients ◽

10.3390/nu13051652 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1652

Author(s):

Margaret Charnley ◽

Lisa Newson ◽

Andrew Weeks ◽

Julie Abayomi

Keyword(s):

Pregnant Women ◽

Maternal Obesity ◽

Maternal Nutrition ◽

Saturated Fatty Acids ◽

Poor Quality ◽

Dietary Quality ◽

Obstetric Outcomes ◽

Dietary Intakes ◽

Singleton Pregnancy ◽

Cross Sectional

Good maternal nutrition is key to optimal maternal and foetal health. A poor-quality diet is often associated with obesity, and the prevalence and severity of maternal obesity has increased significantly in recent years. This study observed dietary intakes in pregnant women living with obesity and assessed the quality of their diet. In total, 140 women with a singleton pregnancy, aged > 18 years and BMI ≥ 35 kg/m2, were recruited from antenatal clinics, weighed and completed food diaries at 16-, 28- and 36-weeks’ gestation. Clinical data were recorded directly from the women’s medical records. Nutrient intake was determined using ‘MicrodietTM’, then compared to Dietary Reference Values (DRVs). Energy intakes were comparable with DRVs, but intakes of sugar and saturated fatty acids were significantly higher. Intake of fibre and several key micronutrients (Iron, Iodine, Folate and Vitamin D) were significantly low. Several adverse obstetric outcomes were higher than the general obstetric population. Women with obesity, often considered ‘over nourished’, may have diets deficient in essential micronutrients, often associated with poor obstetric outcomes. To address the intergenerational transmission of poor health via poor diets warrants a multi-disciplinary approach focusing away from ‘dieting’ onto positive messages, emphasising key nutrients required for good maternal and foetal health.

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The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0464 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Murat Akbas ◽

Faik Mumtaz Koyuncu ◽

Burcu Artunç-Ülkümen ◽

Gökce Akbas

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Value Added ◽

Shear Wave Elastography ◽

Multiple Regression Model ◽

Low Risk ◽

Obstetric Outcomes ◽

Second Trimester ◽

The Mean ◽

Random Measurements

AbstractObjectivesIncreased placental stiffness is associated with various pathological conditions. Our objective was to evaluate the relation between the second-trimester placental elasticity value in low-risk pregnant women and poor obstetric outcomes.MethodsA total of 143 pregnant women were enrolled. Placental elasticity values were measured using the transabdominal point shear wave elastography method. 10 random measurements were obtained from different areas of the placenta. The mean was accepted as the mean placental elasticity value. Logistic regression analyses were performed to identify independent variables associated with obstetric outcomes.ResultsSecond-trimester placental elasticity value was significantly and positively associated with the poor obstetric outcomes (p=0.038). We could predict a poor outcome with 69.2% sensitivity and 60.7% specificity if we defined the placental elasticity cut-off as 3.19 kPa. Furthermore, in the multiple regression model, the placental elasticity value added significantly to the prediction of birth weight (p=0.043).ConclusionsOur results showed that the pregnancies with a stiffer placenta in the second trimester were associated with an increased likelihood of exhibiting poor obstetric outcomes. Also, placental elasticity was independently associated with birth weight.

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The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽

10.1177/09612033211004716 ◽

2021 ◽

pp. 096120332110047

Author(s):

Katarina Bremme ◽

Sonja Honkanen ◽

Iva Gunnarsson ◽

Roza Chaireti

Keyword(s):

Caesarean Section ◽

Lupus Nephritis ◽

Pregnant Women ◽

Lupus Erythematosus ◽

Premature Birth ◽

Renal Involvement ◽

Significant Risk ◽

Obstetric Outcomes ◽

Increased Risk ◽

Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

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