AB0342\u2005OBSTETRIC AND THROMBOTIC ANTIPHOSPHOLIPID SYNDROME: ARE THEY DIFFERENT ENTITIES?

Abstract

<jats:sec><jats:p>Several studies showed two main clinical phenotypes of antiphospholipid syndrome (APS): thrombotic (TAPS) and obstetric APS (OAPS). Although they have the same autoantibody profile, one of them developed thrombosis and other one obstetric morbidity.</jats:p></jats:sec><jats:sec><jats:p>To study clinical, demographic and antibody profile in patients with TAPS and OAPS.</jats:p></jats:sec><jats:sec><jats:p>we retrospectively evaluated TAPS and OAPS patients who were included in Argentine Antiphospholipid antibodies registry. We studied clinical, demographic and antibody profile in both groups.</jats:p></jats:sec><jats:sec><jats:p>238 patients were included in the registry. 201 (84.81%) of them were female. 122 (60.69 %) of them fullfilled APS Sydney classification criteria, 47 (38.52%) TAPS and 52 (42.62%) OAPS. 23 (18.85%) patients had both thrombotic and obstetric events so they were excluded in this analysis.</jats:p><jats:p>Arterial Hypertension (HBP) and Hyperlipidemia were more frequent in TAPS versus OAPS. Older age was found in TAPS as well as in association with Systemic lupus erythematosus (SLE). There was no difference in antibody profile between the 2 groups, and the Global Antiphospholipid Syndrome Score (aGAPSS) was higher in TAPS than OAPS.</jats:p><jats:p>18 (38.3%) of TAPS patients had at least 1 pregnancy. Mean number of pregnancies of TAPS was 2.5 (1.10) and 3.84 (1.86) in OAPS. Thrombotic events were not found in TAPS during pregnancy and puerperium. HBP and gestational diabetes (GD) and other pregnancy related comorbidities were found in TAPS.</jats:p><jats:table-wrap id= T1 position= float orientation= portrait ><jats:table><jats:tbody><jats:tr><jats:td align= center rowspan= 1 colspan= 1 /><jats:td align= center rowspan= 1 colspan= 1 >OAPS (n=52)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >TAPS (n=47)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >P</jats:td><jats:td align= center rowspan= 1 colspan= 1 /><jats:td align= center rowspan= 1 colspan= 1 >OAPS<jats:break />(n=52)</jats:td><jats:td align= center rowspan= 1 colspan= 1 /><jats:td align= center rowspan= 1 colspan= 1 >TAPS(n=18)</jats:td><jats:td align= center rowspan= 1 colspan= 1 /></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >SLE, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >11 (21.2)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >28 (59.6)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.0002</jats:td><jats:td align= center rowspan= 1 colspan= 1 /><jats:td align= center rowspan= 1 colspan= 1 >N</jats:td><jats:td align= center rowspan= 1 colspan= 1 >% (DE)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >N</jats:td><jats:td align= center rowspan= 1 colspan= 1 > % (DE)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >aGAPSS, <jats:italic>mean (RIQ</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4 (5)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >8 (5)</jats:td><jats:td align= center rowspan= 1 colspan= 1 ><0.0001</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Abortions (<10 weeks)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >33</jats:td><jats:td align= center rowspan= 1 colspan= 1 >38.4 (36.2)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >8</jats:td><jats:td align= center rowspan= 1 colspan= 1 >26.5 (35.3)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Age, mean <jats:italic>(DE</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >39.3 (6.24)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >43.1 (13.5)</jats:td><jats:td align= center rowspan= 1 colspan= 1 ><0.0001</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Live Birth</jats:td><jats:td align= center rowspan= 1 colspan= 1 >36</jats:td><jats:td align= center rowspan= 1 colspan= 1 >33.5 (28.1)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >16</jats:td><jats:td align= center rowspan= 1 colspan= 1 >72.2 (34.7)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >HBP, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >5 (9.6)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >15 (31.9)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.0121</jats:td><jats:td align= center rowspan= 1 colspan= 1 > >37 weeks</jats:td><jats:td align= center rowspan= 1 colspan= 1 >21</jats:td><jats:td align= center rowspan= 1 colspan= 1 >16.4 (2.38)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >16</jats:td><jats:td align= center rowspan= 1 colspan= 1 >61.1 (31.7)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Hyperlipidemia, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4 (7.7)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >12(25.5)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.0267</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Prematurity <37 >34 weeks</jats:td><jats:td align= center rowspan= 1 colspan= 1 >11</jats:td><jats:td align= center rowspan= 1 colspan= 1 >8.76 (1.97)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0</jats:td><jats:td align= center rowspan= 1 colspan= 1 >-</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >GD, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >3(5.8)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >2(4.3)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.9999</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Prematurity <34 weeks</jats:td><jats:td align= center rowspan= 1 colspan= 1 >9</jats:td><jats:td align= center rowspan= 1 colspan= 1 >6.37 (1.49)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1.39 (5.89)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Obesity, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >8 (15.4)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4 (8.5)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.2912</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Pre eclampsia >34-<37 weeks</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.490 (0.0350)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >2</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4.6<jats:underline>3 (</jats:underline>0.138)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Smoking, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >11 (21.1)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >13 (27.6)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.4019</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Placental Hematoma</jats:td><jats:td align= center rowspan= 1 colspan= 1 >3</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1.86 (8.18)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1</jats:td><jats:td align= center rowspan= 1 colspan= 1 >2.78 (11.8)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Sedentary lifestyle, <jats:italic>n (%</jats:italic>)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >16 (30.8)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >17 (36.2)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >0.8486</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Abruptio Placentae</jats:td><jats:td align= center rowspan= 1 colspan= 1 >2</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1.96 (9.80)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >2</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4.17 (12.9)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Triple Positivity</jats:td><jats:td align= center rowspan= 1 colspan= 1 >5<jats:break />9.6</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4<jats:break />8.5</jats:td><jats:td align= center rowspan= 3 colspan= 1 >0.8323</jats:td><jats:td align= center rowspan= 1 colspan= 1 > Normal delivery</jats:td><jats:td align= center rowspan= 1 colspan= 1 >20</jats:td><jats:td align= center rowspan= 1 colspan= 1 >17.8 (27.9)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >14</jats:td><jats:td align= center rowspan= 1 colspan= 1 >47.7 (33.9)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Double Positivity</jats:td><jats:td align= center rowspan= 1 colspan= 1 >1<jats:break />1.9</jats:td><jats:td align= center rowspan= 1 colspan= 1 >3<jats:break />6.4</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Cesarean section</jats:td><jats:td align= center rowspan= 1 colspan= 1 >22</jats:td><jats:td align= center rowspan= 1 colspan= 1 >17.2 (21.6)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >2</jats:td><jats:td align= center rowspan= 1 colspan= 1 >11.1 (32.3)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 >Simple Positivity</jats:td><jats:td align= center rowspan= 1 colspan= 1 >29<jats:break />38.5</jats:td><jats:td align= center rowspan= 1 colspan= 1 >19<jats:break />40.4</jats:td><jats:td align= center rowspan= 1 colspan= 1 >Urgent Cesarean section</jats:td><jats:td align= center rowspan= 1 colspan= 1 >13</jats:td><jats:td align= center rowspan= 1 colspan= 1 >9.80 (20.3)</jats:td><jats:td align= center rowspan= 1 colspan= 1 >4</jats:td><jats:td align= center rowspan= 1 colspan= 1 >12.5 (24.6)</jats:td></jats:tr><jats:tr><jats:td align= center rowspan= 1 colspan= 1 /><jats:td align= center rowspan= 1