Laboratory and clinical features of pregnant women with antiphospholipid syndrome and neonatal outcome

Abstract

Objective: To evaluate the relationship between the antiphospholipid profile and clinical characteristics of pregnant women with antiphospholipid syndrome (APS) and neonatal outcome.

Methods: We retrospectively considered 109 treated pregnancies of 93 patients with primary APS and reviewed the medical records of their 111 infants. Neonatal outcome was assessed using the following variables: weeks of gestational age at delivery, percentiles of birth weight, Apgar score at 5 minutes, need for cardiopulmonary resuscitation in the delivery room, time in the neonatal intensive care unit, infections, and other neonatal complications. Univariate statistical analysis was performed to evaluate the relationship between APS maternal features and neonatal outcome parameters.

Results: When maternal APS features and variables of infant outcome were analyzed, it was evident that lupus anticoagulant (LAC), triple antiphospholipid positivity, and history of vascular thrombosis were significantly associated with some parameters of a poor infant outcome. History of pregnancy morbidity alone was, instead, significantly correlated to the variables of favorable neonatal outcome.

Conclusion: There seems to be more than one kind of pregnant woman with APS. Even when treated with a second-line therapy plan, mothers with LAC and/or triple antiphospholipid positivity and/or previous thromboembolism seem to have a high probability of poor neonatal outcome, whereas those with pregnancy morbidity alone, treated with conventional drugs, seem to have a high probability of favorable outcome.