The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases |
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| Authors: | Jaume Alijotas-Reig Enrique Esteve-Valverde Raquel Ferrer-Oliveras Luis Sáez-Comet Elmina Lefkou Arsène Mekinian Cristina Belizna Amelia Ruffatti Angela Tincani Luca Marozio Gerard Espinosa Ricard Cervera Roberto Ríos-Garcés Sara De Carolis Omar Latino Elisa LLurba Cecilia Beatrice Chighizola Maria Gerosa Inmaculada Farran-Codina |
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| Affiliation: | 1. Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d''Hebron University Hospital, Department of Medicine, Universitat Autonoma, Barcelona, Spain;2. Internal Medicine Department, Althaia Healthcare Network of Manresa, Systemic Autoimmune Disease Unit, Manresa, Barcelona, Spain;3. Obstetrics and Gynaecology Department, High Risk Unit, Vall d''Hebron University Hospital, Universitat Autonoma, Barcelona, Spain;4. Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain;5. Haematology Unit, Hippokration Hospital of Thessaloniki, Greece;6. AP-HP, Hôpital Saint-Antoine, Service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ Paris 06, F-75012 Paris, France;7. Vascular and Coagulation Department, University Hospital Angers, Angers, France;8. Rheumatology Unit, Department of Clinical and Experimental Medicine Azienda Ospedaliera, University of Padua, Padua, Italy;9. Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili, Brescia, Italy;10. Department of Obstetrics and Gynaecology, Università di Torino, Torino, Italy;11. Systemic Autoimmune Diseases Service, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain;12. Department of Woman, Child Health and Public Health, F.Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;13. Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr. Carlos G Durand Hospital, Buenos Aires, Argentina;14. Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;15. Division of Rheumatology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;p. Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy;q. Department of Paedriatics, Department Clinical Sciences, Faculty of Medicine, University of Turku, Turku, Finland;r. Pregnancy and Rheumatic Diseases Clinic, Unit of Medicine and Clinical Immunology, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milano, Italy;s. Department of Obstetrics, Medical University Graz, Graz, Austria;t. Department of Systemic Rheumatic Disease, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia;u. Department of Gynecology Obstetrics and Urology, “Sapienza” University of Rome, Rome, Italy;v. Internal Medicine, “Bezanijska Kosa,” University Medical Center, Belgrade, Serbia;w. Clinical Research Unit, Althaia Healthcare University Network of Manresa, Manresa, Barcelona, Spain;x. Internal Medicine Department, Althaia Healthcare Network of Manresa, Manresa, Universitat Autònoma, Barcelona, Spain;y. Department of Laboratory Medicine, Althaia Healthcare University Network of Manresa, Manresa, Barcelona, Spain;z. Urology Department, Andrology and Male Reproductive Unit, Vilafranca del Penedès Hospital, Barcelona, Spain;11. Obstetrics and Gynaecology Department, High Risk Unit, Althaia Healthcare University Network of Manresa, Manresa, Barcelona, Spain |
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| Abstract: | AimTo analyse the clinical features, laboratory data and foetal-maternal outcomes, and follow them up on a cohort of 1000 women with obstetric antiphospholipid syndrome (OAPS).MethodsThe European Registry of OAPS became a registry within the framework of the European Forum on Antiphospholipid Antibody projects and was placed on a website in June 2010. Thirty hospitals throughout Europe have collaborated to carry out this registry. Cases with obstetric complaints related to antiphospholipid antibodies (aPL) who tested positive for aPL at least twice were included prospectively and retrospectively. The seven-year survey results are reported.Results1000 women with 3553 episodes were included of which 2553 were historical and 1000 were latest episodes. All cases fulfilled the Sydney classification criteria. According to the laboratory categories, 292 (29.2%) were in category I, 357 (35.7%) in IIa, 224 (22.4%) in IIb and 127 (12.7%) in IIc. Miscarriages were the most prevalent clinical manifestation in 386 cases (38.6%). Moreover, the presence of early preeclampsia (PE) and early foetal growth restriction (FGR) appeared in 181 (18.1%) and 161 (16.1%), respectively. In this series, 448 (44.8%) women received the recommended OAPS treatment. Patients with recommended treatment had a good live-birth rate (85%), but worse results (72.4%) were obtained in patients with any treatment (low-dose aspirin (LDA) or low-molecular-weight heparin (LMWH) not on recommended schedule, while patients with no treatment showed a poor birth rate (49.6%).ConclusionIn this series, recurrent miscarriage is the most frequent poor outcome. To avoid false-negative diagnoses, all laboratory category subsets were needed. OAPS cases have very good foetal-maternal outcomes when treated. Results suggest that we were able to improve our clinical practice to offer better treatment and outcomes to OAPS patients. |
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| Keywords: | Antiphospholipid antibody Antiphospholipid syndrome Obstetric antiphospholipid syndrome Registry Pregnancy autoimmune disorders |
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