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. 2024 Nov;92(5):e70013.
doi: 10.1111/aji.70013.

Pregnancy Outcomes in Grand Multiparity Women With Antiphospholipid Antibodies

Keren Zloto  1   2 , Shani Steinberg  2 , Shir Lev  2 , Rakefet Yoeli-Ullman  1   2 , Stanley Niznik  3 , Nancy Agmon-Levin  2   3 , Keren Ofir  1   2
Affiliations

Pregnancy Outcomes in Grand Multiparity Women With Antiphospholipid Antibodies

Keren Zloto et al. Am J Reprod Immunol. 2024 Nov.

Abstract

Objective: In recent years antiphospholipid syndrome (APS) as well as antiphospholipid antibodies (aPL) prevalence has demonstrated an upward trend in women during reproductive age. There is a lack of data concerning its effects on women with grand multiparity (GMP) (parity ≥5). Hence, this study aimed to assess pregnancy outcomes among GMP aPL/APS patients.

Study design: We retrospectively assembled the births of GMP women with aPL/APS, between 2017 and 2022 in the Sheba Medical Center. We compared their deliveries with those of two control groups: (1) the "aPL/APS-controls"-of pregnant women with aPL/APS and parity <5. (2) The "GMP-controls"- parity ≥5 without aPL/APS. We examined demographics, aPL characteristics, pregnancy, and neonatal outcomes between the groups.

Results: In total, 42 deliveries in the study group were compared to 461 deliveries in the "aPL/APS-controls" group and 84 deliveries of the "GMP-controls." Most parameters were similar across groups. However, the study group had a higher rate of obstetric APS diagnosis (64.64% vs. 83.33%, p < 0.01) and showed significant differences such as older maternal age, higher BMI, more polyhydramnios cases, and larger babies compared to controls (33.91 vs. 36.19, p = 0.05; 23.2 vs. 28.89, p = 0.02; 3.68 vs. 11.9, p = 0.01; and 2.17 vs. 14.28, p < 0.01, respectively).

Conclusions: Our findings reveal that perinatal outcomes in aPL/APS GMP women are comparable and not inferior to those in aPL/APS women with <5 pregnancies or in comparison to the general GMP population. The minor differences observed may all be related to GMP women's older age and higher BMI.

Keywords: antiphospholipid syndrome; grand multiparity; pregnancy outcome.

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