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首页> 外文期刊>Journal of Reproductive Immunology >The impact of various entities of antiphospholipid antibodies positivity on adverse pregnancy outcome. An epidemiological perspective
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The impact of various entities of antiphospholipid antibodies positivity on adverse pregnancy outcome. An epidemiological perspective

机译：抗磷脂抗体各种实体对不良妊娠结局的影响。 流行病学观点

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摘要

The aim of the study was to evaluate the rate of obstetric complications and the burden of obstetric outcomes in antiphospholipid syndrome (APS), non-criteria APS and asymptomatic antiphospholipid antibodies (aPL) carriers. From 2013-2018, 163 pregnant subjects with aPL antibodies and 785 controls were enrolled. Penalized logistic regression was used to compare obstetric complications. Cases included 62 complete APS (38 %), 48 non-criteria APS (29.4 %) and 53 (32.5 %) asymptomatic aPLcarriers. Connective tissue diseases (CTDs) were diagnosed in 31.3 % of cases. The rate of high-risk aPL profile was higher (p < .01) in APS (67.7 %) compared to non-criteria (14.6 %) and aPL-carriers (9.4 %). Double/ triple positivity was 33.9 % (p < .05 compared to non-criteria and aPL-carriers) in APS, 10.4 % in non-criteria and 9.4 % in aPL-carriers. The rate of adverse pregnancy outcomes were 5.6 % in controls, 41.9 % (adj.OR = 6.95 %CI = 2.7-13.5) in APS, 25 % (adj.OR = 4.4,95 %CI = 2-9.4) in non-criteria and 28.3 % (OR = 4.95 %CI = 1.8-8.8) in aPL-carriers. CTDs were independently associated with an increased risk of adverse obstetric outcomes (OR = 2.8,95 %CI = 1.36-5.89). The attributable fraction (AF) of adverse obstetric events was higher among low-risk antibodies compared to high-risk (AF = 0.27,95 %CI = 0.22-0.31 vs AF = 0.16,95 %CI = 0.16-0.2,p < .01) and among single positivity compared to double/triple positivity (AF = 0.32,95 %CI = 0.26-0.37 vs AF = 0.11,95 %CI = 0.09-0.13,p < .01) suggesting that low-risk subjects are responsible for a high burden of obstetric complications.
机译：本研究的目的是评估抗磷脂综合征（APS）、非标准APS和无症状抗磷脂抗体（aPL）携带者的产科并发症发生率和产科结局负担。从2013年到2018年，163名携带aPL抗体的孕妇和785名对照者被纳入研究。惩罚逻辑回归用于比较产科并发症。病例包括62例完全APS（38%）、48例非标准APS（29.4%）和53例无症状APL携带者（32.5%）。31.3%的病例诊断为结缔组织病（CTD）。APS患者的高危aPL发生率（67.7%）高于非标准患者（14.6%）和aPL携带者（9.4%）。APS的双/三重阳性率为33.9%（与非标准和aPL携带者相比，p<0.05），非标准和aPL携带者分别为10.4%和9.4%。对照组不良妊娠结局发生率为5.6%，APS组为41.9%（adj.OR=6.95%CI=2.7-13.5），非标准组为25%（adj.OR=4.4,95%CI=2-9.4），aPL携带者为28.3%（OR=4.95%CI=1.8-8.8）。CTD与不良产科结局风险增加独立相关（OR=2.8,95%CI=1.36-5.89）。产科不良事件的归因分数（AF）在低风险抗体组中高于高风险抗体组（AF=0.27,95%CI=0.22-0.31 vs AF=0.16,95%CI=0.16-0.2，p<0.01），在单次阳性组中高于双/三次阳性组（AF=0.32,95%CI=0.26-0.37 vs AF=0.11,95%CI=0.09-0.13，p<0.01），表明低风险受试者对高负担的产科不良事件负有责任产科并发症。

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