TOPLINE

Women with systemic lupus erythematosus (SLE) who tested positive for antiphospholipid antibodies (aPLs) were more likely to experience adverse pregnancy outcomes than those without these antibodies.

METHODOLOGY

• Researchers conducted a single-center cohort study at a Chinese hospital to determine whether aPLs and specific aPL profiles were associated with adverse pregnancy outcomes in patients with SLE.
• They analyzed data from 441 singleton pregnancies in 410 patients with SLE (mean maternal age, 30.80 years) between January 2013 and January 2024.
• aPL profiles included anticardiolipin (aCL) immunoglobulin G/M (IgG/IgM), anti‑β2 glycoprotein I (anti‑β2GPI) IgG/IgM, and lupus anticoagulant.
• The primary outcome was a composite adverse pregnancy outcome defined as prefetal death with loss of pregnancy before 10 weeks, fetal death (loss of pregnancy between 10 and 34 weeks), severe preeclampsia before 34 weeks, or placental insufficiency with severe features before 34 weeks.

TAKEAWAY

• Overall, 17.9% of pregnancies were positive for aPLs and 16.1% experienced an adverse pregnancy outcome.
• Patients with positive aPLs had 2.56-fold higher odds of adverse pregnancy outcomes than those without aPLs in an adjusted analysis (P = .002).
• aPL positivity was associated with 3.87-fold increased odds of fetal death and 2.54-fold higher odds of failure of live birth (P < .05 for both).
• The highest odds (3.98-fold) of adverse pregnancy outcomes were observed when lupus anticoagulant and IgG aCL/anti‑β2GPI were both present (P = .002). Other combinations of aPL positivity showed no clear association.

IN PRACTICE

"The findings of this study highlight the importance of risk stratification and individualized management among patients with SLE who are positive for aPLs, putting more focus on those with LA [lupus anticoagulant] plus IgG isotypes of aCL and/or anti-β2GPI antibodies, to achieve favorable pregnancy outcomes," the authors of the study wrote.

SOURCE

The study was led by Xueyang Zhang and Can Huang, Peking Union Medical College Hospital in Beijing, China. It was published online on July 30 in RMD Open.

LIMITATIONS

Missing pregnancy outcome data for some individuals may have introduced bias. Detailed information on newborns was not recorded. All participants were Chinese and were recruited from a single center.

DISCLOSURES

The study was supported by multiple sources, including the Chinese National Key Technology R&D Programme, Ministry of Science and Technology, and the National Natural Science Foundation of China. The authors did not declare any competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.