14th International Congress on Antiphospholipid Antibodies Task Force Report on Obstetric Antiphospholipid Syndrome

Guilherme R. De Jesus*, Nancy Agmon-Levin, Carlos A. Andrade, Laura Andreoli, Cecilia B. Chighizola, T. Flint Porter, Jane Salmon, Robert M. Silver, Angela Tincani, D. Ware Branch

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Pregnancy morbidity is one of the clinical manifestations used for classification criteria of antiphospholipid syndrome (APS). During the 14th International Congress on Antiphospholipid Antibodies (aPL), a Task Force with internationally-known experts was created to carry out a critical appraisal of the literature available regarding the association of aPL with obstetric manifestations present in actual classification criteria (recurrent early miscarriage, fetal death, preeclampsia and placental insufficiency) and the quality of the evidence that treatment(s) provide benefit in terms of avoiding recurrent adverse obstetric outcomes. The association of infertility with aPL and the effectiveness of the treatment of patients with infertility and positive aPL was also investigated. This report presents current knowledge and limitations of published studies regarding pregnancy morbidity, infertility and aPL, identifying areas that need better investigative efforts and proposing how critical flaws could be avoided in future studies, as suggested by participants of the Task Force. Except for fetal death, there are limitations in the quality of the data supporting the association of aPL with obstetric complications included in the current APS classification criteria. Recommended treatments for all pregnancy morbidity associated to APS also lack well-designed studies to confirm its efficacy. APL does not seem to be associated with infertility and treatment does not improve the outcomes in infertile patients with aPL. In another section of the Task Force, Dr. Jane Salmon reviewed complement-mediated inflammation in reproductive failure in APS, considering new therapeutic targets to obstetric APS (Ob APS).

Original languageEnglish
Pages (from-to)795-813
Number of pages19
JournalAutoimmunity Reviews
Volume13
Issue number8
DOIs
StatePublished - Aug 2014

Keywords

  • Antiphospholipid syndrome
  • Complement
  • Fetal death
  • Infertility
  • Preeclampsia
  • Recurrent early miscarriage

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