Recurrent Pregnancy Loss and Antiphospholipde Syndrome

Background: Recent studies report an increased prevalence of antiphospholipid antibodies among patients with recurrent IVF rendering the syndrome potentially responsible for the autoimmune reproductive failure at different levels of reproduction.

Objective: The aim was to investigate the pregnancy outcomes in patients with antiphospholipid syndrome (APS).

Methods: Study included 55 patients with APS who controlled their pregnancy at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancy outcomes including miscarriage, preterm delivery and intrauterine fetal death (IUFD) were registered and compared between groups. We noted the antybody count, applied therapy as well as the outcome of current pregnancy and associated these parameters with obstetric history in patients with APS.

Results: Examined women form both groups had similar number of previous pregnancies (range=1-5; mean+/-sd=1.29+/-1.35) (χ²=1.158; p=0.212). Therе were 38 APS patients with recurrent adverse pregnancy outcomes. The rate of recurrent miscarriages in APS patients was 72.8%, the recurrent premature delivery 2.7% and IUFD was 24.5%. Significantly more patients with APS than those in the control group had past history of recurrent miscarriages (χ²=13.138; p=0.001), preterm deliveries (χ²=19.459 p=0.001) or IUFDs (χ²=14.550; p=0.001). Higher antybody count correlated with more previous adverse outcomes (ρ=0.512; p=0.001). Use of corticosteroids (ρ= -0.296; p=0.002) and salicylic acid (ρ= -0.405; p=0.001) reduced the rate of pregnancy loss in future pregnancies of patients with APS. Moreover, the less miscarriages women with APS previously had, the better will be the outcome of actual pregnancy (ρ= -0.239; p=0.030).

Conclusion: We confirmed that recurrent pregnancy loss is frequent in APS patients. Moreover, past obstetric history presents a significant prognostic factor for outcome of future pregnancies in patients with APS. Still, adequate treatment of women with APS can reduce pregnancy loss rate.