Abstract
The association between unconventional antiphospholipid antibodies and pre-eclampsia in patients without thrombotic manifestations and its relationship with endothelial dysfunction after delivery has been studied poorly. We included 157 pregnant women, 122 of them having developed pre-eclampsia (56 non-severe and 66 severe). The determination of classical and unconventional, as well as pulse wave velocity and ankle-brachial index were performed at three months after delivery. The prevalence of unconventional antiphospholipid antibodies was 22.9% and 54.9% in patients included in control and pre-eclampsia groups, respectively (p = 0.001). The most frequent antiphospholipid antibody was IgM anti-phosphatidylserine/prothrombin in both cohorts. The presence of IgM anti-phosphatidylserine/prothrombin showed an association with the development of pre-eclampsia (OR = 5.4; CI 95% (2.0–14.9), p = 0.001) with an AUC of 0.744 (p < 0.001). Likewise, IgM anti-phosphatidylserine/prothrombin exhibited a positive linear correlation with pulse wave velocity values (rho = 0.830; p < 0.001) and an association with the presence of pulse wave velocity altered values (OR = 1.33; CI95% (1.10–1.59), p = 0.002). With regard to ankle braquial index values, the presence of IgM anti-phosphatidylserine/prothrombin displayed a weak negative correlation (rho = −0.466; p < 0.001) and an association with altered ankle braquial index values (OR = 1.08; CI 95% (1.04–1.13), p < 0.001). In patients who developed preeclampsia, the presence of IgM anti-phosphatidylserine/prothrombin could be associated with endothelial dysfunction, causing alteration of cardiovascular parameters.
Highlights
Pre-eclampsia (PE) is a hypertensive disorder of pregnancy, whose presentation includes the combination of maternal new-onset hypertension, which occurs most often after 20 weeks of gestation and frequently near term, and proteinuria, or evidence of other end-organ damage in the absence of proteinuria [1,2]
Our main finding was that unconventional aPL was related to the previous development of PE and, besides, related to a higher PE severity
The results obtained in the present work corroborate certain aspects described in previous studies and provide a new perspective on the role of aPLs and endothelial dysfunction parameters in the context of PE
Summary
Pre-eclampsia (PE) is a hypertensive disorder of pregnancy, whose presentation includes the combination of maternal new-onset hypertension, which occurs most often after 20 weeks of gestation and frequently near term, and proteinuria, or evidence of other end-organ damage in the absence of proteinuria [1,2]. In pregnant women, this disease can cause a multisystem disease with central nervous system disturbances, liver, hematologic or renal dysfunction; and in the fetus, a fetal growth. In late-onset PE, the endothelial cell dysfunction has been linked to maternal “constitutional” factors, such as chronic hypertension, age, obesity or diabetes mellitus [9]
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