Association of lupus anticoagulants with risk factors for obstetric complications and adverse gestational outcome

Abstract

BACKGROUND:

Lupus anticoagulant (LA) may be a cause of poor obstetric outcome.

OBJECTIVE:

To search the association of LA with risk factors for obstetric complications and adverse gestational outcome.

METHODS:

This retrospective cohort was consisted of 2 groups of pregnancies with poor obstetric history; 1) LA ( $+$ ) gestations (Study Group, $n=$ 20) and 2) LA ( $-$ ) gestations (Control Group, 78). All patients were admitted to a special antenatal care program and were examined in terms of risk factors for thrombotic events, placenta-related obstetric complications, and poor gestational outcomes. Patients were administered low-dose low-molecular-weight heparin (LMWH), low-dose salicylic acid and low-dose corticosteroid (if necessary) within the framework of a prophylaxis protocol in addition to their already existing medications.

RESULTS:

We have shown that adverse gestational outcome was 1.7-fold more frequent in LA ( $+$ ) pregnancies with poor obstetric history ( $p=$ 0.039, 70% vs. 41%). Higher rates of autoimmune diseases and hereditary thrombophilia were observed among LA ( $+$ ) patients compared to LA ( $-$ ) gestations (35% vs. 10.3%, $p<$ 0.012 and 55% vs. 19.2%, $p<$ 0.003, respectively). To identify the effectiveness of low-dose LMWH prophylaxis protocol, we compared gestational outcomes and demonstrated that the miscarriage rate was significantly decreased to half in current pregnancies compared to the previous gestations (73.6% vs. 35%, $p=$ 0.003).

CONCLUSIONS:

Autoimmune diseases and hereditary thrombophilia are more frequent in LA ( $+$ ) pregnancies, and these women are prone to obstetric problems. Low-dose LMWH and salicylic acid prophylaxis are critical in the management of LA ( $+$ ) pregnant women.