Association of lupus anticoagulants with risk factors for obstetric complications and adverse gestational outcome

ÇAĞAN M., DÖNMEZ H. G., DİKMEN Z. G., BEKSAÇ M. S.

Human antibodies, vol.31, no.1-2, pp.1-8, 2023 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 1-2
  • Publication Date: 2023
  • Doi Number: 10.3233/hab-230003
  • Journal Name: Human antibodies
  • Journal Indexes: Scopus, Academic Search Premier, BIOSIS, Biotechnology Research Abstracts, EMBASE, MEDLINE
  • Page Numbers: pp.1-8
  • Keywords: Adverse gestational outcome, autoimmune disorders, hereditary thrombophilia, lupus anticoagulants, miscarriage, preterm birth
  • Hacettepe University Affiliated: Yes

Abstract

BACKGROUND: Lupus anticoagulant (LA) may be a cause of poor obstetric outcome. OBJECTIVE: To search the association of LA with risk factors for obstetric complications and adverse gestational outcome. METHODS: This retrospective cohort was consisted of 2 groups of pregnancies with poor obstetric history; 1) LA (+) gestations (Study Group, n= 20) and 2) LA (-) gestations (Control Group, 78). All patients were admitted to a special antenatal care program and were examined in terms of risk factors for thrombotic events, placenta-related obstetric complications, and poor gestational outcomes. Patients were administered low-dose low-molecular-weight heparin (LMWH), low-dose salicylic acid and low-dose corticosteroid (if necessary) within the framework of a prophylaxis protocol in addition to their already existing medications. RESULTS: We have shown that adverse gestational outcome was 1.7-fold more frequent in LA (+) pregnancies with poor obstetric history (p= 0.039, 70% vs. 41%). Higher rates of autoimmune diseases and hereditary thrombophilia were observed among LA (+) patients compared to LA (-) gestations (35% vs. 10.3%, p< 0.012 and 55% vs. 19.2%, p< 0.003, respectively). To identify the effectiveness of low-dose LMWH prophylaxis protocol, we compared gestational outcomes and demonstrated that the miscarriage rate was significantly decreased to half in current pregnancies compared to the previous gestations (73.6% vs. 35%, p= 0.003). CONCLUSIONS: Autoimmune diseases and hereditary thrombophilia are more frequent in LA (+) pregnancies, and these women are prone to obstetric problems. Low-dose LMWH and salicylic acid prophylaxis are critical in the management of LA (+) pregnant women.