Exploring the association between Preeclampsia and antiphospholipid antibodies. New insights on the clinical criteria of APS. A prospective study

Objectives: to study prospectively the presence aPL on pregnant women at time of preeclampsia (PE) diagnosis in comparison with normal pregnant controls (I), to determine the association between aPL and diagnosis of severe preeclampsia and (II) to evaluate the association between the presence of aPL and severe preeclampsia before and after 34 weeks of gestations. Study Design: This prospective, interventional, and analytical study included one hundred forty women who were tested for aPL during pregnancy and separated in 2 groups based on their diagnostic status of PE. Group 1: forty normal pregnant women studied for aPL beyond 20 weeks of pregnancy, followed until the birth of a full-term new-born baby and Group 2: one hundred women studied for aPL at the time of PE onset/diagnosis. We evaluated and compared rates of aPL positivity between Group 1 and 2. Results: We compared the presence of aPL between group 1 10,0% (4/40) and group 2 34,0% (34/100). We found an association between severe PE and aPL positivity [OR= 4.63 (95% CI: 1.523 – 14.107), p =0.005]. We also found an association between LA and severe PE [OR= 6.0 (95% CI: 1.3466 – 26.7335), p =0.01]. We confirmed an association between early severe PE and the presence of aPL positivity [OR= 4,384 (95% CI: 1.3615 – 14.1206), p = 0.01]. We also found an association between late severe PE and the presence of aPL positivity [OR= 5.0 (95% CI: 1.4901 – 16.777), p = 0.008]. We compared the presence of aPL between patients with early severe PE 25,9% (19/58) and patients with late severe PE 23,8% (15/42). No significant association was found between the 2 groups. These results suggest that the positivity of aPL and gestational age are independent, and both related to their severity. Conclusion : These results suggest that the presence of aPL is associated to the severe PE. The positivity of aPL is associated to the severity of PE, independently from gestational age. We suggest including the study aPL in women with severe PE independently of prematurity.