He Lauren, Sims Catherine
Division of Rheumatology, University of Michigan, Ann Arbor, Michigan.
Division of Rheumatology, Duke University, Durham, North Carolina.
Semin Reprod Med. 2024 Sep;42(3):197-208. doi: 10.1055/s-0044-1790225. Epub 2024 Oct 24.
Antiphospholipid syndrome (APS) is a disease characterized by the presence of antiphospholipid (aPL) antibodies, thrombosis, and obstetric complications. While patients with APS can have successful pregnancies, many important considerations exist. APS can also cooccur with other systemic autoimmune diseases which can affect pregnancy, particularly systemic lupus erythematosus. This article reviews specific considerations for pregnancy and reproductive health in patients with APS. Similar to other autoimmune diseases, stable or quiescent disease and planning with a rheumatologist and obstetrician prior to conception are vital components of a successful pregnancy. Pregnancy management for patients with aPL antibodies or diagnosis of APS with aspirin and/or anticoagulation depending on disease profile is discussed, as well as the effects of physiologic changes during pregnancy in maternal and fetal outcomes for this population. Given the reproductive span lasts beyond conception through delivery, we include discussions on safe contraception options, the use of assistive reproductive technology, pregnancy termination, menopause, and male fertility. While APS is a relatively rare condition, the effects this disease can have on maternal and fetal outcomes even with available therapies demonstrates the need for more high-quality, evidence-based research.
抗磷脂综合征（APS）是一种以存在抗磷脂（aPL）抗体、血栓形成和产科并发症为特征的疾病。虽然APS患者可以成功怀孕，但仍有许多重要的注意事项。APS也可能与其他可影响妊娠的全身性自身免疫性疾病同时发生，尤其是系统性红斑狼疮。本文综述了APS患者妊娠和生殖健康的具体注意事项。与其他自身免疫性疾病类似，病情稳定或静止，以及在受孕前与风湿病学家和产科医生共同制定计划，是成功妊娠的关键因素。本文讨论了根据疾病情况，使用阿司匹林和/或抗凝剂对aPL抗体阳性患者或诊断为APS患者进行妊娠管理，以及妊娠期间生理变化对该人群母婴结局的影响。鉴于生殖期从受孕持续到分娩，我们还讨论了安全避孕方法、辅助生殖技术的使用、终止妊娠、绝经和男性生育能力。虽然APS是一种相对罕见的疾病，但即使有可用的治疗方法，这种疾病对母婴结局的影响表明，需要进行更多高质量、基于证据的研究。
