scholarly journals Association of Differential Metabolites With Small Intestinal Microflora and Maternal Outcomes in Subclinical Hypothyroidism During Pregnancy

2022 ◽  
Vol 11 ◽  
Author(s):  
Jingjing Li ◽  
Yajuan Xu ◽  
Yanjun Cai ◽  
Miao Zhang ◽  
Zongzong Sun ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Intestinal Microflora ◽  
Negative Ion ◽  
Control Group ◽  
Maternal Outcomes ◽  
Hypertensive Disorder ◽  
Hydrogen Breath Test ◽  
Glycocholic Acid ◽  
Small Intestinal

ObjectiveTo investigate the association of differential metabolites with small intestinal microflora and maternal outcomes in subclinical hypothyroidism (SCH) during pregnancy.MethodsThe plasma of pregnant women in the SCH group and control group was analyzed by liquid chromatography-mass spectrometry (LC-MS), obtaining differential metabolites. Then, methane and hydrogen breath tests were performed in both groups, and basic clinical data and maternal outcome information were collected. Finally, differential metabolites were analyzed for small intestinal bacterial overgrowth (SIBO) and pregnancy outcomes using Spearman correlation analysis.Results(1) Multivariate statistics: There were 564 different metabolites in positive ion mode and 226 different metabolites in negative ion mode. (2) The positive rate of the methane hydrogen breath test in the SCH group was higher than that in the control group (p<0.05). (3) KEGG pathway analysis revealed that differential metabolites were mainly involved in bile secretion, cholesterol metabolism, and other pathways. (4) Serum cholesterol (TC) and triglyceride (TG) levels and hypertensive disorder complicating pregnancy (HDCP) were higher in the SCH group (p<0.05), and newborn birth weight (BW) was lower than that in the control group (p<0.05). (5) SIBO was negatively correlated with glycocholic acid and BW, and positively correlated with TC. Glycocholic acid was negatively correlated with TG but positively correlated with BW. TG was positively correlated with HDCP.ConclusionDifferential metabolites in the SCH group during pregnancy were disordered with small intestinal bacteria, which may affect pregnancy outcomes, and bile acids and cholesterol may be potential biomarkers for studying their mechanism of action.

scholarly journals Pregnancy outcomes in patients with rheumatoid arthritis and systemic lupus erythematosus. Part I. Maternal outcomes

2019 ◽  
Vol 57 (2) ◽  
pp. 180-185 ◽  
Author(s):  
N. M. Kosheleva ◽  
E. V. Matyanova ◽  
E. V. Fedorova ◽  
N. I. Klimenchenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Control Group ◽  
Maternal Outcomes ◽  
Third Trimester ◽  
Systemic Lupus ◽  
Arterial Perfusion

Improved diagnosis and treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) contribute to the remission of the disease and improve the quality of life of patients. In this regard, more and more women with RA and SLE decide to have pregnancy, which makes it actual to study the features of its course and outcomes in these diseases.Objective: to evaluate maternal pregnancy outcomes in patients with RA and SLE.Subjects and methods. 76 cases of pregnancy were traced prospectively in 72 patients: 32 pregnancies in 29 patients with RA and 44 pregnancies in 43 patients with SLE.Results and discussion. 72 of 76 (94.7%) supervised pregnancies ended in childbirth with the birth of a viable baby. There were three cases of pregnancy loss in the second trimester in SLE patients with concomitant antiphospholipid syndrome (AFS) and one case (3.1%) of perinatal infant death (a boy and a girl, monochorionic diamniotic twins with reverse arterial perfusion syndrome) in a patient with seropositive RA. Compared with the all-Russian population, the supervised RA and SLE patients more often had prematurely birth (37.5‰, 18.7% and 22.7%) and caesarean section (CS; in 236.7‰, 50%, and 56.8% respectively). In the SLE group CS was conducted due to the emergency reasons more frequently than in RA, (respectively 47,7% and 25%, relative risk of 1.9 [1; 3.7]; p=0.04). CS at the first birth was performed more often during RA and SLE than before the onset of the disease (p<0.001). Preeclampsia in patients with RA was diagnosed more often than in the population (9.4% and 15.7 per 1000 births, respectively). There was a reverse correlation between the timing of delivery and disease activity according DAS28-CRP in II (r= 0.5; p=0.01) and III (r= 0.6; p=0.0005) trimesters of pregnancy, and in patients with moderate and high activity of RA in the third trimester (n=12) delivery was earlier than in the control group (n=20), remission or low activity of RA (p<0.01). In patients with SLE who had birth prematurely (22.7%), the duration of the disease (p=0.02) and the duration of oral glucocorticoid therapy (p=0.003) were greater compared with SLE patients having term birth (70.5%); the dose of glucocorticoids at the time of conception and delivery did not affect the timing of delivery.Conclusion. Planning of pregnancy in patients with RA and SLE, monitoring during pregnancy and timely correction of therapy contribute to uncomplicated course of gestation and improve maternal outcomes.

scholarly journals Evaluation of Perinatal Outcome in Women with Impaired Glucose Homeostasis During Pregnancy

2021 ◽  
Vol 28 (2) ◽  
pp. 185-192
Author(s):  
Neha SAHAY ◽  
◽  
Felice FAIZAL ◽  
Keyword(s):  
Glucose Tolerance ◽  
Glucose Homeostasis ◽  
Secondary Outcome ◽  
Control Group ◽  
Maternal Outcomes ◽  
Study Group ◽  
Hypertensive Disorder ◽  
Increased Risk ◽  
Group 3 ◽  
And Control

Background: Glucose tolerance testing in pregnancy identifies many women with glycaemic responses that exceed normal range but that do not meet the threshold required to diagnose Gestational Diabetes Mellitus. It is controversial whether maternal hyperglycemia less severe than in diabetes is associated with increased risk of adverse pregnancy outcome or not. Materials and methods: All women were subjected to Glucose Challenge Test(GCT) with 50 gram glucose either at first visit or between 24-28 weeks on the basis of risk profile. High risk cases were screened at first visit and the rest between 24-28 weeks. Patients with a GCT value ≥200mg/dl were not subjected for GTT and were diagnosed as GDM.Value of GCT <140 mg/dl was taken as normal. Irrespective of GCT result, women were subjected to Oral Glucose Tolerance Test (OGTT) as recommended by WHO with 75 gram glucose using WHO criteria. Study group was identified with 4 categories with abnormal glucose homoeostasis as defined by the following criteria: 1. Abnormal GCT (>140 mg/dl) with normal OGTT; 2. Normal GCT with only Impaired Fasting Glucose(IFG) in OGTT; 3. Normal GCT with Gestational Glucose Intolerance(GGI); 4. Patients diagnosed as GDM: a. If fasting is >126mg/dl; b. If 2hr OGTT ≥ 140mg/dl & ≤ 199 mg/dl; c. If value of either GCT or OGTT >200 mg/dl. The control group comprised of women with normal GCT and normal OGTT. In all the above groups, adverse prenatal outcome and maternal outcomes were evaluated by the primary and secondary outcome measures. Results: There were 10 cases (15.3%) of hypertensive disorder of pregnancy in the study group (3 cases of gestational hypertension in abnormal GCT, 3 cases of pre eclampsia in each GGI and GDM and 1 antepartum eclampsia in GGI category) and 2 cases in control group (3%) (p=0.03). There were 2 cases of Fetal Growth Reduction (FGR) and 5 cases of Premature Rupture Of Membranes(PROM) in both study and control group. There was 1 case of cholestasis of pregnancy in study group. Term inductions were 11 and 13 in the study and control group respectively.Within the study group number of cases induced were more in GGI(n=7) and GDM(n=4) category. There were 14 caesarean sections (21.5%) and 2 (3%) instrumental deliveries among the study group. However there were 6 caesarean sections (9.2%) and no instrumental deliveries among control groups. The rate of elective LSCS is more in GDM (n=5) vs other 3 categories and the difference is significant (p=0.04) The overall number of LSCS (14 cases) was significantly higher in GDM. Conclusion: Cases with abnormal glucose homeostasis of lesser degree than GDM, like only abnormal GCT, IFG and GGI also were observed to have adverse maternal outcomes than controls, in form of hypertensive disorders of pregnancy, significantly higher LSCS rates, and increased risk of macrosomia. Instead of 2 step procedure, single step screening cum diagnostic test with 75 gm OGTT for diagnosing GDM could be an option to be universally practiced.

scholarly journals Differential lipids in pregnant women with subclinical hypothyroidism and their correlation to the pregnancy outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jingjing Li ◽  
Yajuan Xu ◽  
Zongzong Sun ◽  
Yanjun Cai ◽  
Biao Wang ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
Pregnant Women ◽  
Lipid Profile ◽  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Differentially Expressed ◽  
Control Group ◽  
Pathway Enrichment Analysis ◽  
Lipid Metabolism Disorders ◽  
In Pregnancy

AbstractSubclinical hypothyroidism (SCH) has become a prevalent complication in pregnancy. Recent research links SCH to disturbed thyroid lipid profile; however, it is unclear how lipid metabolism disorders contribute to the pathogenesis of SCH during pregnancy. Thus, we used nontargeted lipidomics to identify and compare the lipids and metabolites expressed by pregnant women with SCH and healthy pregnant women. Multivariate analysis revealed 143 lipid molecules differentially expressed between the SCH group and the control group. Based on fold change, 30 differentially expressed lipid metabolites are potential biomarkers. KEGG pathway enrichment analysis showed that the differentially expressed metabolites participate in several pathways, including response to pathogenic Escherichia coli infection, regulation of lipolysis in adipocytes, metabolic pathways, glycerophospholipid metabolism, and fat digestion and absorption pathways. Correlation analyses revealed sphingomyelin (SM) and phosphatidylcholine (PC) positively correlate to tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6), while phosphatidylglycerol (PG), and phosphatidylinositol (PI) negatively correlate with them. In addition, PG positively correlates to birth weight. Thus, the lipid profile of pregnant women with SCH is significantly different from that of healthy pregnant women. Lipid molecules associated with the differential lipid metabolism, such as SM, phosphatidylethanolamine (PE), and PI, should be further investigated for their roles in the pathogenesis of SCH in pregnancy, as they might be targets for reducing the incidence of adverse pregnancy outcomes.

scholarly journals Lipid Characteristics of Pregnant Women With Subclinical Hypothyroidism and Their Correlation to the Pregnancy Outcomes

2021 ◽  
Author(s):  
Jingjing Li ◽  
Yajuan Xu ◽  
Zongzong Sun ◽  
Yanjun Cai ◽  
Biao Wang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Metabolic Pathways ◽  
Enrichment Analysis ◽  
Control Group ◽  
Pathway Enrichment Analysis ◽  
Adverse Pregnancy ◽  
Factor Α ◽  
In Pregnancy

Abstract Subclinical hypothyroidism (SCH) in pregnancy has become an important complication of pregnancy. We used nontargeted lipidomics to compare differential metabolites between women with SCH and healthy women. The metabolic pathways of the differential metabolites were analyzed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. We found: 1. Multivariate analysis revealed 143 lipid molecules with different levels between the SCH group and the control group. Based on fold change, 30 differential lipid metabolites were selected as potential biomarkers. 2. KEGG pathway enrichment analysis showed that the differential metabolites participate in such pathways as pathogenic Escherichia coli infection response, metabolic pathways, glycerophospholipid metabolism. 3. Correlation analysis showed that sphingomyelin (SM) and phosphatidylcholine (PC) were positively correlated with tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6), while phosphatidylglycerol (PG), and phosphatidylinositol (PI) were negatively correlated with them. And PG was positively correlated with birth weight. The lipid profile of pregnant women with SCH is significantly different from that of healthy pregnant women. Lipid molecules with differential metabolism, such as SM, PE, and PI, might be targets for further investigation of the pathogenesis of SCH in pregnancy and reduce the incidence of adverse pregnancy outcomes.

scholarly journals Small Intestinal Bacterial Overgrowth in Subclinical Hypothyroidism of Pregnant Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Biao Wang ◽  
Yajuan Xu ◽  
Xiaofeng Hou ◽  
Jingjing Li ◽  
Yanjun Cai ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Intestinal Bacteria ◽  
Abdominal Distension ◽  
Small Intestinal Bacterial Overgrowth ◽  
Control Group ◽  
Study Group ◽  
Small Intestinal

ObjectiveTo evaluate the small intestinal bacterial overgrowth (SIBO) of subclinical hypothyroidism of pregnant women, and explore their possible relevance.MethodsIn total, 224 pregnant women with subclinical hypothyroidism during pregnancy (study group) and 196 pregnant women whose thyroid function was normal (control group) were enrolled in this study. Lactulose-based hydrogen and methane breath test was performed to evaluate the growth of intestinal bacteria. The serum-free thyroid hormone (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), body mass index (BMI) and gastrointestinal symptoms were detected and recorded.ResultsThe positive rates of SIBO were 56.7% and 31.6% in study group and control group, respectively. The levels of C response protein (CRP), abdominal distension and constipation in study group were higher than those in the control group. The risk of abdominal distension and constipation in SIBO-positive pregnant women were higher than that in SIBO-negative pregnant women, and the BMI of SIBO-positive patients in the two groups was lower than that of SIBO-negative patients in each group. In addition, the TPOAb-positive rate and TSH levels were higher but the FT4 level was lower in SIBO-positive patients compared to SIBO-negative patients in study group.ConclusionThe occurrence of subclinical hypothyroidism is related to SIBO, and the excessive growth of small intestinal bacteria may affect gastrointestinal symptoms.Clinical Trialhttp://www.chictr.org.cn/index.aspx, identifier ChiCTR1900026326.

scholarly journals Levothyroxine and the risk of adverse pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Magnus Bein ◽  
Oriana Hoi Yun Yu ◽  
Sonia Marzia Grandi ◽  
Francesca Y. E. Frati ◽  
Ihab Kandil ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Observational Studies ◽  
Pregnancy Loss ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy ◽  
Levothyroxine Treatment

Abstract Background Levothyroxine replacement therapy may decrease the risk of adverse pregnancy outcomes among women with subclinical hypothyroidism (SCH). The aim of this study is to conduct a systematic review and meta-analysis to examine the risk of adverse pregnancy, perinatal, and early childhood outcomes among women with SCH treated with levothyroxine. Methods A systematic literature search was conducted using Ovid-Medline, Ovid-EMBASE, Pubmed (non-Medline), Ebsco-CINAHL Plus with full text and Cochrane Library databases. Randomized controlled studies (RCTs) and observational studies examining the association between treatment of SCH during pregnancy and our outcomes of interest were included. Studies that compared levothyroxine treatment versus no treatment were eligible for inclusion. Data from included studies were extracted and quality assessment was performed by two independent reviewers. Results Seven RCTs and six observational studies met our inclusion criteria. A total of 7342 individuals were included in these studies. RCTs demonstrated several sources of bias, with lack of blinding of the participants or research personnel; only one study was fully blinded. In the observational studies, there was moderate to serious risk of bias due to lack of adjustment for certain confounding variables, participant selection, and selective reporting of results. Pooled analyses showed decreased risk of pregnancy loss (RR: 0.79; 95% CI: 0.67 to 0.93) and neonatal death (RR: 0.35; 95% CI: 0.17 to 0.72) associated with levothyroxine treatment during pregnancy among women with SCH. There were no associations between levothyroxine treatment and outcomes during labour and delivery, or cognitive status in children at 3 or 5 years of age. Conclusion Treatment of SCH with levothyroxine during pregnancy is associated with decreased risks of pregnancy loss and neonatal death. Given the paucity of available data and heterogeneity of included studies, additional studies are needed to address the benefits of levothyroxine use among pregnant women with SCH.

Thyroid Functions in Children on Levetiracetam or Valproic Acid Therapy

2020 ◽  
Author(s):  
Elif Karatoprak ◽  
Samet Paksoy
Keyword(s):  
Valproic Acid ◽  
Subclinical Hypothyroidism ◽  
Control Group ◽  
Thyroid Function Tests ◽  
Healthy Children ◽  
Control Groups ◽  
Acid Therapy ◽  
Significant Difference ◽  
And Control ◽  
Tsh Levels

AbstractThe aim of this study was to investigate the thyroid functions in children receiving levetiracetam or valproate monotherapy. We retrospectively reviewed the records of children with controlled epilepsy receiving valproic acid (VPA group) or levetiracetam monotherapy (LEV group) for at least 6 months. Free thyroxine 4 levels (fT4) and thyroid stimulating hormone (TSH) levels were compared between VPA group, LEV group, and age- and gender-matched healthy children (control group). A total of 190 children were included in the study: 63 were in the VPA, 60 in the LEV, and 67 in the control group. Although there was no significant difference regarding average fT4 levels, higher TSH levels were found in the VPA group when compared with the LEV and control groups (p < 0.001 and p < 0.001, respectively). There was no significant difference in terms of fT4 and TSH values in the LEV group when compared with the control group (p = 0.56 and p = 0.61, respectively). Subclinical hypothyroidism (defined as a TSH level above 5 uIU/mL with a normal fT4 level was detected in 16% of patients in the VPA group, none in the LEV and control groups. Our study found that VPA therapy is associated with an increased risk of subclinical hypothyroidism while LEV had no effect on thyroid function tests.

scholarly journals Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jane L. Tarry-Adkins ◽  
Susan E. Ozanne ◽  
Catherine E. Aiken
Keyword(s):  
Side Effects ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Risk Of Bias ◽  
Maternal Outcomes ◽  
Metformin Treatment ◽  
Eligibility Criteria ◽  
Treatment Groups ◽  
Gastrointestinal Side Effects ◽  
The Impact

AbstractWe systematically assessed the impact of metformin treatment on maternal pregnancy outcomes. PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov and Cochrane databases were systematically searched (inception-1st February 2021). Randomised controlled trials reporting pregnancy outcomes in women randomised to metformin versus any other treatment for any indication were included. Outcomes included gestational weight gain (GWG), pre-eclampsia, gestational hypertension, preterm birth, gestational age at delivery, caesarean section, gestational diabetes, glycaemic control, and gastrointestinal side-effects. Two independent reviewers conducted screening, with a third available to evaluate disagreements. Risk-of-bias and GRADE assessments were conducted using Cochrane Risk-of-Bias and GRADE-pro software. Thirty-five studies (n = 8033 pregnancies) met eligibility criteria. GWG was lower in pregnancies randomised to metformin versus other treatments (1.57 kg ± 0.60 kg; I2 = 86%, p < 0.0001), as was likelihood of pre-eclampsia (OR 0.69, 95% CI 0.50–0.95; I2 = 55%, p = 0.02). The risk of gastrointestinal side-effects was greater in metformin-exposed versus other treatment groups (OR 2.43, 95% CI 1.53–3.84; I2 = 76%, p = 0.0002). The risk of other maternal outcomes assessed was not significantly different between metformin-exposed versus other treatment groups. Metformin for any indication during pregnancy is associated with lower GWG and a modest reduced risk of pre-eclampsia, but increased gastrointestinal side-effects compared to other treatments.

Influence of microbial species on small intestinal myoelectric activity and transit in germ-free rats

2001 ◽  
Vol 280 (3) ◽  
pp. G368-G380 ◽  
Author(s):  
Einar Husebye ◽  
Per M. Hellström ◽  
Frank Sundler ◽  
Jie Chen ◽  
Tore Midtvedt
Keyword(s):  
Small Intestine ◽  
Intestinal Microflora ◽  
Burst Activity ◽  
Intestinal Transit ◽  
Myoelectric Activity ◽  
Regular Spike ◽  
Spike Burst ◽  
Germ Free ◽  
Microbial Species ◽  
Small Intestinal

The effect of an intestinal microflora consisting of selected microbial species on myoelectric activity of small intestine was studied using germ-free rat models, with recording before and after specific intestinal colonization, in the unanesthetized state. Intestinal transit, neuropeptides in blood (RIA), and neuromessengers in the intestinal wall were determined. Clostridium tabificum vp 04 promoted regular spike burst activity, shown by a reduction of the migrating myoelectric complex (MMC) period from 30.5 ± 3.9 min in the germ-free state to 21.2 ± 0.14 min ( P < 0.01). Lactobacillus acidophilus A10 and Bifidobacterium bifidum B11 reduced the MMC period from 27.9 ± 4.5 to 21.5 ± 2.1 min ( P < 0.02) and accelerated small intestinal transit ( P < 0.05). Micrococcus luteus showed an inhibitory effect, with an MMC period of 35.9 ± 9.3 min compared with 27.7 ± 6.3 min in germ-free rats ( P < 0.01). Inhibition was indicated also for Escherichia coli X7gnotobiotic rats. No consistent changes in slow wave frequency were observed. The concentration of neuropeptide Y in blood decreased after introduction of conventional intestinal microflora, suggesting reduced inhibitory control. Intestinal bacteria promote or suppress the initiation and aboral migration of the MMC depending on the species involved. Bacteria with primitive fermenting metabolism (anaerobes) emerge as important promoters of regular spike burst activity in small intestine.

Neonatal outcome in pregnant patients with antiphospholipid syndrome

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Katarina Jeremic ◽  
Aleksandar Stefanovic ◽  
Jelena Dotlic ◽  
Jelena Stojnic ◽  
Sasa Kadija ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Distress Syndrome ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Distress Syndrome ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Asphyxia ◽  
Premature Delivery ◽  
Control Group ◽  
Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

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