Amikam Uri, Hochberg Alyssa, Shenhav Michael, Haj Lilian, Hochberg-Klein Sarit, Hiersch Liran, Yogev Yariv
Lis Hospital for Women, Sourasky Medical Center, Tel Aviv 6423906, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
J Clin Med. 2023 Jul 6;12(13):4516. doi: 10.3390/jcm12134516.
To determine the prevalence of positive antiphospholipid (aPL) antibodies among pregnant women with placenta-mediated complications delivered at >34 weeks of gestation.
This was a single-center retrospective observational study conducted between 2017 and 2022. Inclusion criteria included pregnant or post-partum women, >18 years, diagnosed with any of the following placenta-mediated complications and delivered at >34 weeks of gestation: small-for-gestational-age neonate (SGA ≤ 5th percentile according to local birthweight charts), preeclampsia with severe features, and placental abruption. The primary outcome was the prevalence of positive aPL antibodies: Lupus anticoagulant, Anticardiolipin, or Anti-ß2glycoprotein1.
Overall, 431 women met the inclusion criteria. Of them, 378(87.7%) had an SGA neonate, 30 had preeclampsia with severe features (7%), 23 had placental abruption (5.3%), and 21 patients had multiple diagnoses(4.9%). The prevalence of aPL antibodies in the cohort was 4.9% and was comparable between the three subgroups (SGA-3.9%; PET with severe features-3.3%; and placental abruption-13% ( = 0.17)).
aPL antibodies prevalence in women with placenta-mediated complications > 34 weeks of gestation was 4.9%, with comparable prevalence rates among the three subgroups. Future prospective studies are needed to delineate the need for treatment in those who tested positive for aPL antibodies and do not meet Anti-Phospholipid Antibody Syndrome clinical criteria.
确定孕周大于34周分娩的胎盘介导并发症孕妇中抗磷脂（aPL）抗体阳性的患病率。
这是一项于2017年至2022年期间进行的单中心回顾性观察研究。纳入标准包括年龄大于18岁的孕妇或产后妇女，诊断为以下任何一种胎盘介导并发症且孕周大于34周分娩：小于胎龄儿（根据当地出生体重图表，SGA≤第5百分位数）、重度子痫前期和胎盘早剥。主要结局是aPL抗体阳性的患病率：狼疮抗凝物、抗心磷脂或抗β2糖蛋白1。
总体而言，431名女性符合纳入标准。其中，378名（87.7%）有小于胎龄儿，30名有重度子痫前期（7%），23名有胎盘早剥（5.3%），21名患者有多种诊断（4.9%）。队列中aPL抗体的患病率为4.9%，在三个亚组之间具有可比性（小于胎龄儿组-3.9%；重度子痫前期组-3.3%；胎盘早剥组-13%（P = 0.17））。
孕周大于34周的胎盘介导并发症女性中aPL抗体患病率为4.9%，三个亚组的患病率具有可比性。未来需要进行前瞻性研究，以确定aPL抗体检测呈阳性且不符合抗磷脂抗体综合征临床标准的患者是否需要治疗。
