International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
Reassessing the role of antiphospholipid antibodies in placental-mediated adverse pregnancy outcomes in systemic lupus erythematosus: A retrospective cohort study.
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Jiang Meng, Chang Yanling, Zhang Ning, Di Wen, Wu Jiayue
Аннотация
OBJECTIVE: To examine how different antiphospholipid antibody (aPL) profiles influence placental-mediated adverse pregnancy outcomes (APOs) in women with systemic lupus erythematosus (SLE).
METHODS: This retrospective cohort study included 245 pregnant women with SLE and 490 controls from a single center. Clinical features, immunologic markers and aPL profiles were analyzed. Logistic regression models were used to explore associations between antiphospholipid syndrome (APS), individual aPL subtypes, antibody burden and placental-mediated APOs.
RESULTS: Placental-mediated APOs occurred more often in SLE pregnancies than in controls (27.8% vs. 9.8%). After adjustment, APS was not independently associated with APOs. Renal involvement, chronic hypertension and hypocomplementemia remained significant predictors (P < 0.05). Among antibody types, lupus anticoagulant (LAC) showed the strongest association in univariate analysis, but the effect weakened in multivariable analysis. Women with multiple aPL positivity had a higher risk of placental complications, whereas single positivity showed little independent effect.
CONCLUSION: In SLE pregnancies, obstetric risk is not explained by APS alone. Antibody burden, especially multiple aPL positivity, together with renal disease, hypertension and complement levels appears more informative for assessing placental-related risk.
METHODS: This retrospective cohort study included 245 pregnant women with SLE and 490 controls from a single center. Clinical features, immunologic markers and aPL profiles were analyzed. Logistic regression models were used to explore associations between antiphospholipid syndrome (APS), individual aPL subtypes, antibody burden and placental-mediated APOs.
RESULTS: Placental-mediated APOs occurred more often in SLE pregnancies than in controls (27.8% vs. 9.8%). After adjustment, APS was not independently associated with APOs. Renal involvement, chronic hypertension and hypocomplementemia remained significant predictors (P < 0.05). Among antibody types, lupus anticoagulant (LAC) showed the strongest association in univariate analysis, but the effect weakened in multivariable analysis. Women with multiple aPL positivity had a higher risk of placental complications, whereas single positivity showed little independent effect.
CONCLUSION: In SLE pregnancies, obstetric risk is not explained by APS alone. Antibody burden, especially multiple aPL positivity, together with renal disease, hypertension and complement levels appears more informative for assessing placental-related risk.