Maternal and fetal outcome in women with antiphospholipid syndrome: a three-year observational study.

OBJECTIVES

To assess prospectively the maternal and fetal outcome in women with primary antiphospholipid syndrome (APS) and to find out predictors of poor obstetric outcome.

METHODS

A prospective observational study included 162 patients with primary APS who were divided into two groups, group 1 with previous thrombosis (n = 74) and group 2 without previous thrombosis (n = 88). Patients were followed from the start of pregnancy till delivery under standard treatment to detect maternal and fetal outcome.

RESULTS

There was a significant difference between the two groups with higher rate of miscarriage (p < 0.05), maternal venous thromboembolism (p < 0.001), intrauterine fetal demise and neonatal death (p < 0.05) in group 1. No significant difference between the two groups regarding the rate of preeclampsia, eclampsia, postpartum hemorrhage, prematurity and admission to neonatal intensive care unit (p > 0.05). By univariate and multivariate analyzes in the whole study participants, previous thrombosis, triple positivity of APS antibodies, previous delivery before 34 weeks, the presence of antiβ2GP1 antibodies and maternal age above 30 years were independent predictors of pregnancy loss.

CONCLUSION

Poor obstetric outcome is higher in patients with previous thrombosis. The search for optimal prognostic markers and new therapeutic measures to prevent complications in APS patients is warranted.