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. 2019 Apr;18(4):406-414.
doi: 10.1016/j.autrev.2018.12.006. Epub 2019 Feb 15.

The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases

Jaume Alijotas-Reig  1 , Enrique Esteve-Valverde  2 , Raquel Ferrer-Oliveras  3 , Luis Sáez-Comet  4 , Elmina Lefkou  5 , Arsène Mekinian  6 , Cristina Belizna  7 , Amelia Ruffatti  8 , Angela Tincani  9 , Luca Marozio  10 , Gerard Espinosa  11 , Ricard Cervera  11 , Roberto Ríos-Garcés  11 , Sara De Carolis  12 , Omar Latino  13 , Elisa LLurba  14 , Cecilia Beatrice Chighizola  15 , Maria Gerosa  15 , Vittorio Pengo  16 , Krista Lundelin  17 , Patrizia Rovere-Querini  18 , Valentina Canti  18 , Karoline Mayer-Pickel  19 , Tatiana Reshetnyak  20 , Ariela Hoxha  8 , Sara Tabacco  21 , Ldjumila Stojanovich  22 , Vassiliki Gogou  5 , Aikaterini Varoudis  5 , Anna Arnau  23 , Domingo Ruiz-Hidalgo  24 , Jaume Trapé  25 , Laia Sos  26 , Carlotta Stoppani  27 , Anna Martí-Cañamares  27 , Inmaculada Farran-Codina  3 ; EUROAPS Study Group
Affiliations

The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases

Jaume Alijotas-Reig et al. Autoimmun Rev. 2019 Apr.

Abstract

Aim: To analyse the clinical features, laboratory data and foetal-maternal outcomes, and follow them up on a cohort of 1000 women with obstetric antiphospholipid syndrome (OAPS).

Methods: The European Registry of OAPS became a registry within the framework of the European Forum on Antiphospholipid Antibody projects and was placed on a website in June 2010. Thirty hospitals throughout Europe have collaborated to carry out this registry. Cases with obstetric complaints related to antiphospholipid antibodies (aPL) who tested positive for aPL at least twice were included prospectively and retrospectively. The seven-year survey results are reported.

Results: 1000 women with 3553 episodes were included of which 2553 were historical and 1000 were latest episodes. All cases fulfilled the Sydney classification criteria. According to the laboratory categories, 292 (29.2%) were in category I, 357 (35.7%) in IIa, 224 (22.4%) in IIb and 127 (12.7%) in IIc. Miscarriages were the most prevalent clinical manifestation in 386 cases (38.6%). Moreover, the presence of early preeclampsia (PE) and early foetal growth restriction (FGR) appeared in 181 (18.1%) and 161 (16.1%), respectively. In this series, 448 (44.8%) women received the recommended OAPS treatment. Patients with recommended treatment had a good live-birth rate (85%), but worse results (72.4%) were obtained in patients with any treatment (low-dose aspirin (LDA) or low-molecular-weight heparin (LMWH) not on recommended schedule, while patients with no treatment showed a poor birth rate (49.6%).

Conclusion: In this series, recurrent miscarriage is the most frequent poor outcome. To avoid false-negative diagnoses, all laboratory category subsets were needed. OAPS cases have very good foetal-maternal outcomes when treated. Results suggest that we were able to improve our clinical practice to offer better treatment and outcomes to OAPS patients.

Keywords: Antiphospholipid antibody; Antiphospholipid syndrome; Obstetric antiphospholipid syndrome; Pregnancy autoimmune disorders; Registry.

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