The association between different types of antiphospholipid antibodies and pre-eclampsia

الملخص EN

Objectives: To evaluate the levels of lupus anticoagulant and different anticardiolipin antibodies in pregnancies complicated by pre-eclamptic toxaemia (PET) in comparison to normal pregnancies, and to evaluate the impact of those antibodies on pregnancy outcome.

Participants: Seventy pregnant women were divided into two groups: Group 1: women with PET (n= 60) who were further subdivided into mild PET (n= 40) and severe PET (n= 20); and Group 2: women with normal pregnancies (n= 10).

Setting: Bab El-Sharia University Hospital, Cairo, Egypt.

Methods: Lupus anticoagulant (LA) and anticardiolipin antibodies (ACA's) (IgG and IgM) were measured using activated partial thromboplastin time (aPTT) and ELISA, respectively.

Mode of delivery, fetal outcome as regards birthweight, APGAR score at 1 and 5 minutes and the occurrence of IUGR were recorded, and their association with levels of the aforementioned antibodies was sought.

Results: ACA IgG was significantly higher in cases with PET, whether mild or severe, in comparison to normal pregnancies (mild PET vs control = 10.99 vs 7.18 GPL, P< 0.05; severe PET vs control = 16.12 vs 7.18 GPL, P< 0.01).

ACA IgM was not significantly different.

LA was significantly higher in mild PET (aPTT = 35 vs 31 s, P< 0.05) and in severe PET (35.25 vs 31 s, P< 0.05) in comparison to normal pregnancies.

As regards fetal outcome, only ACA IgG was significantly higher in severe PET with IUGR as compared to normally growing fetuses (17.6 vs 15.1 GPL, P< 0.05).

Both ACA IgG and IgM were significantly higher in cases of PET where the neonate had low APGAR score of < 7 at 5 minutes as compared to normal APGAR score (IgG = 19.8 vs 11.2 GPL, P< 0.05; IgM = 9.5 vs 5.9 MPL, P< 0.05).

Conclusion: Antiphospholipid antibodies comprise a family of different antibodies.

Some of them are high in PET (e.g.

ACA IgG and IgM), others are not (e.g.

LA).

Different antibodies are associated with different adverse pregnancy outcomes.