Anti-Phosphatidylserine/Prothrombin Antibodies Are Associated with Adverse Pregnancy Outcomes.

Polona Žigon,Saša Čučnik,Borut Božič,Katja Perdan Pirkmajer,Aleš Ambrožič,Tanja Kveder,Matija Tomšič,Snežna Sodin Šemrl

doi:10.1155/2015/975704

Abstract

Objective. To determine the prevalence and clinical association of anti-phosphatidylserine/prothrombin antibodies (aPS/PT) in patients with a history of pregnancy complications relevant to antiphospholipid syndrome (APS). Materials and Methods. Two hundred and eleven patients with a history of (a) three or more consecutive miscarriages before 10th week of gestation (WG) (n = 64), (b) death of a morphologically normal fetus beyond 10th WG (n = 72), (c) premature birth of a morphologically normal neonate before 34th WG due to eclampsia, preeclamsia and placental insufficiency (n = 33), and (d) less than three unexplained consecutive miscarriages before 10th WG (n = 42). Subjects sera were analyzed for lupus anticoagulant (LA), anti-cardiolipin (aCL), anti-β 2-glycoprotein I (anti-β 2GPI), and aPS/PT antibodies. Results. 41/169 (24.3%) of patients were positive for at least one measured aPL. The highest prevalence was found for aPS/PT and aCL (13.0% and 12.4%, resp.) followed by LA (7.7%) and anti-β 2GPI (7.1%). 11/169 with APS-related obstetric manifestations had only aPS/PT. 17.8% of patients were positive for LA or aCL and/or anti-β 2GPI; however when adding the aPS/PT results, an additional 7% of patients could be evaluated for APS. Conclusion. aPS/PT are associated with recurrent early or late abortions and with premature delivery irrespective of other aPL.

Highlights

Patients with elevated levels of antiphospholipid antibodies often experience pregnancy complications comprising recurrent spontaneous abortions, intrauterine growth retardation, and preeclampsia, suggesting that these antibodies may influence embryonic implantation and induce thrombosis of the uteroplacental vasculature
These antibodies can be detected by an ELISA targeting prothrombin alone or targeting phosphatidylserine/prothrombin complex [8]; the latter are more frequently found in patients with antiphospholipid syndrome (APS) [4, 9, 10]
Our group reported on an in-house aPS/PT ELISA as the optimal method for the determination of clinically relevant antiprothrombin antibodies exhibiting the highest proportion of lupus anticoagulants (LA) in our population of patients [11]

Summary

Introduction

Patients with elevated levels of antiphospholipid antibodies (aPL) often experience pregnancy complications comprising recurrent spontaneous abortions, intrauterine growth retardation, and preeclampsia, suggesting that these antibodies may influence embryonic implantation and induce thrombosis of the uteroplacental vasculature. Many studies demonstrated the association of antiprothrombin antibodies with the pathogenesis of APS [2,3,4] and some of them proposed their beneficial role for APS diagnosis [5,6,7]. These antibodies can be detected by an ELISA targeting prothrombin alone (aPT-A) or targeting phosphatidylserine/prothrombin complex (aPS/PT) [8]; the latter are more frequently found in patients with APS [4, 9, 10]. A comprehensive review of “antiprothrombin antibodies” and “pregnancy/obstetric/miscarriages/fetal loss” revealed 12 studies, comprising 1031 patients and 988 controls

Methods

Results

Discussion

Conclusion