Anti-β2-glycoprotein I antibodies are associated with pregnancy loss in women with the lupus anticoagulant

Thomas Sailer; Claudia Zoghlami; Christine Kurz; Helmut Rumpold; Peter Quehenberger; Simon Panzer; Ingrid Pabinger

doi:10.1160/TH06-01-0044

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 95(05): 796-801
DOI: 10.1160/TH06-01-0044

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Anti-β2-glycoprotein I antibodies are associated with pregnancy loss in women with the lupus anticoagulant

Thomas Sailer

¹Department of Internal Medicine I, Division of Haematology and Haemostaseology

,

Claudia Zoghlami

¹Department of Internal Medicine I, Division of Haematology and Haemostaseology

,

Christine Kurz

²Department of Obstetrics and Gynaecology

,

Helmut Rumpold

³Institute for Medical and Chemical Laboratory Diagnostics

,

Peter Quehenberger

³Institute for Medical and Chemical Laboratory Diagnostics

,

Simon Panzer

⁴Clinic for Blood Group Serology, Medical University Vienna, Vienna, Austria

,

Ingrid Pabinger

¹Department of Internal Medicine I, Division of Haematology and Haemostaseology

› Author Affiliations

Abstract

Summary

The presence of lupus anticoagulant (LA) predisposes to fetal loss and to venous and arterial thrombosis; however, a subgroup of women is unaffected by pregnancy loss. Currently, no predictive markers are available for the identification of women positive for LA at increased risk for pregnancy loss. It was the aim of our study to investigate whether increased anti-β2-GPI-antibodies predict pregnancy loss in women positive for LA. We performed a cross-sectional study in a cohort of 39 women with persistent LA, who had in total 111 pregnancies. Fifteen women had exclusively normal pregnancies (30 pregnancies) and 24 women had pregnancy losses (81 pregnancies). Anti-β2-GPI-antibodies were determined using a semiquantitative enzyme linked immunoassay (QUANTA Lite^™ β2 GPI IgG and IgM; Inova Diagnostics). Increased levels of anti-β2-GPI antibodies were significantly associated with pregnancy loss [odds ratio (OR) 9.6, 95% confidence interval (CI) 1.6 – 56.4].This risk was even higher in the subgroup of women (n=16) with more than two miscarriages or fetal loss after the first trimester [OR 13.1, 95% CI 1.4 – 126.3]. There was no significant association between anticardiolipin antibodies and pregnancy loss [OR 3.5, 95% CI 0.7 – 17.6].The coexistence of anti-β2-GPI and anticardiolipin antibodies was also predictive for pregnancy loss [OR 6.1, 95%CI 1.3 – 29.7]. Interestingly, the prevalence of thrombosis was similar between women with normal pregnancy (87%) and those with pregnancy loss (75%). We conclude that increased levels of anti-β2-GPI antibodies are predictive for pregnancy loss among women positive for LA, and that prophylactic treatment should be considered in these women even without a history of previous pregnancy loss.

Keywords

Lupus anticoagulant - pregnancy loss - anti-β2-glycoproteinI antibodies - anticardiolipin antibodies - antiphospholipid syndrome

Full Text

References

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