Outcome of Pregnancy in Patients Possessing Anticardiolipin Antibodies

Abstract

Objective – To analyse the outcome of pregnancy in a sample of patients with a history of fetal loss, and possessing anticardiolipin antibodies (ACAs), and to assess the effectiveness of therapy with aspirin and prednisolone. Method – Data on a cohort of 21 Arab and 4 other Asian patients who had one or more episodes of fetal loss associated with raised levels of ACAs were analysed retrospectively. Statistical analysis was performed using χ2 test for assessment of isotype data and the Fischer test for assessment of the effects of therapeutic intervention. Results –Where immunoglobulin G (IgG) ACAs were found alone, abortion rates occurred at the same rate in the first and second trimesters, which was significantly higher than in the third trimester. In the few cases where IgG and immunoglobulin M (IgM) ACAs coexisted, the rate of pregnancy loss was significantly higher in the first trimester than the second and the third. In the group who had received both aspirin and prednisolone, 75% pregnancies were successful compared to 54% in the group receiving aspirin alone and 17% in those who received no therapy. Conclusion – The presence of IgG antibodies appears to increase the risk of abortions. Low dose aspirin, either alone or with prednisolone, appears to significantly improve the chances for successful pregnancies in patients with ACAs. Further clinical trials are needed to ascertain optimal therapeutic protocols.

Keywords

• anticardiolipin, antibody, aspirin, prednisolone, pregnancy