The following is a summary of “Association Between Novel Antiphospholipid Antibodies and Adverse Pregnancy Outcomes,” published in the September 2024 issue of Obstetrics and Gynecology by Moyle et al.   

Antiphospholipid antibodies (aPL) are linked to adverse pregnancy outcomes in individuals with systemic lupus erythematosus (SLE) and other conditions.  

Researchers conducted a prospective study to evaluate the predictive value of anti-β2 glycoprotein-I domain 1 and antiphosphatidylserine–prothrombin antibodies for adverse pregnancy outcomes.  

They analyzed data from 265 pregnant patients with aPL (n=59 with SLE, n=106 without SLE, and n=100 with SLE without aPL). Serum levels of anti-β2 glycoprotein-I domain 1 and antiphosphatidylserine–prothrombin was measured before 18 weeks of gestation, and adverse pregnancy outcomes were defined as delivery before 34 weeks due to preeclampsia or placental insufficiency or fetal death after 12 weeks of gestation.  

 The results showed 265 individuals, 45 experienced adverse pregnancy outcomes, equating to 17.0%. The area under the curve from the receiver operating characteristic analysis was 0.734 (95% CI, 0.664–0.805) for aD1, 0.83 (95% CI, 0.751–0.899) for antiphosphatidylserine–prothrombin immunoglobulin G, and 0.612 (95% CI, 0.520–0.703) for antiphosphatidylserine–prothrombin immunoglobulin M. Significant markers included aD1 (P<.001), anticardiolipin immunoglobulin G (P<.001), β2-glycoprotein I immunoglobulin G (P=.003), antiphosphatidylserine–prothrombin immunoglobulin G (P<.001), antiphosphatidylserine–prothrombin immunoglobulin M (P=.03), and lupus anticoagulant (P<.001). Backward selection revealed lupus anticoagulant (OR 7.0 [95% CI, 3.4–14.4]), aD1 (OR 12.1 [95% CI, 3.64–40.2]), and antiphosphatidylserine–prothrombin immunoglobulin G (OR 11.4 [95% CI, 5.2–25.2]) as significant for adverse pregnancy outcomes. Both aD1 and antiphosphatidylserine–prothrombin immunoglobulin G remained significant when lupus anticoagulant was removed from the model. Both markers effectively ruled in adverse pregnancy outcomes, with a likelihood ratio of less than 0.1 for ruling out outcomes, aD1 and antiphosphatidylserine–prothrombin immunoglobulin G were associated with lupus anticoagulant positivity (OR 27.9 [95% CI, 12.1–64.0]). The highest adverse pregnancy outcome rate, 47.6%, was noted in individuals positive for lupus anticoagulant, aD1, and antiphosphatidylserine–prothrombin immunoglobulin G.  

They concluded that anti-β2 glycoprotein-I domain 1 and antiphosphatidylserine–prothrombin immunoglobulin G were significant independent predictors of adverse pregnancy outcomes in pregnant individuals with aPL.  

Source: journals.lww.com/greenjournal/abstract/9900/association_between_novel_antiphospholipid.1154.aspx