Lockshin M D, Druzin M L, Qamar T
Division of Rheumatic Diseases, Hospital for Special Surgery-Cornell University Medical College, New York, NY 10021.
Am J Obstet Gynecol. 1989 Feb;160(2):439-43. doi: 10.1016/0002-9378(89)90468-7.
Effects of therapy, antibody titer, and pregnancy history on pregnancy outcome were evaluated in pregnancies of women with antiphospholipid antibody. Prior fetal death and a high antiphospholipid antibody titer (greater than 40 IgG phospholipid units) contributed independently, in an additive manner, to current fetal loss. Twenty-one pregnancies occurred in asymptomatic women who had both prior fetal death and a high IgG antiphospholipid antibody titer. In this very high-risk group, 9 of 11 (82%) of pregnancies treated with prednisone, 10 to 60 mg/day, ended in fetal death, compared with 5 of 10 (50%) not treated with prednisone (p approximately 0.01, life-table analysis). Of pregnancies treated with aspirin, 80 mg/day, 9 of 14 (64%) treated and 5 of 7 (71%) not treated with prednisone had a fetal death (difference not significant). Prednisone does not improve, and may worsen, current fetal outcome in asymptomatic pregnant women with a high antiphospholipid antibody titer and prior fetal death.
在抗磷脂抗体阳性的孕妇中，评估了治疗、抗体滴度和妊娠史对妊娠结局的影响。既往胎儿死亡和高抗磷脂抗体滴度（大于40 IgG磷脂单位）以累加方式独立地导致当前胎儿丢失。21例妊娠发生在既往有胎儿死亡且IgG抗磷脂抗体滴度高的无症状女性中。在这个极高风险组中，接受泼尼松治疗（10至60毫克/天）的11例妊娠中有9例（82%）以胎儿死亡告终，而未接受泼尼松治疗的10例中有5例（50%）（生存分析，P约为0.01）。在接受阿司匹林治疗（80毫克/天）的妊娠中，接受泼尼松治疗的14例中有9例（64%）、未接受泼尼松治疗的7例中有5例（71%）发生胎儿死亡（差异不显著）。泼尼松并不能改善，甚至可能恶化有高抗磷脂抗体滴度和既往胎儿死亡的无症状孕妇的当前胎儿结局。
