Anticardiolipin antibodies in first- and second-trimester pregnancy loss

Abstract

Objective: To determine whether a difference exists in the prevalence of anticardiolipin antibodies in patients with a history of recurrent first- versus second-trimester pregnancy loss. Methods: Patients presenting to the Pregnancy Loss Evaluation Service (PLES) from June 1994 to December 1999 were tested for the presence of anticardiolipin IgG, IgM, and IgA antibodies. Levels were measured by a single reference laboratory test. Patients were eligible for the service if they had experienced recurrent first-trimester losses (RFTLs) or at least one second-trimester loss (STL). Comparisons based on the presence of the anticardiolipin antibody were made between patients with RFTL versus STL. Significance was set at P less than 0.05. Results: Anticardiolipin antibody levels were obtained in 93% (243/261) of patients during PLES evaluations. There were 132 patients with RFTL and 129 patients with a STL. 1st-trimester loss 2nd-trimester loss P value Anticardiolipin IgG 6.1% (8/130) 4.4% (5/113) 0.49 Anticardiolipin IgM 7.1% (9/126) 1.7% (2/115) 0.08 Anticardiolipin IgA 2.2% (2/88) 0% (0/78) 0.18 Conclusion: Although the prevalence of anticardiolipin antibodies is greater in patients with first-trimester losses, testing is justified in both first-trimester and second-trimester loss evaluations.