ABSTRACT
To determine if screening for antiphospholipid antibodies in gravid chronic hypertension
patients is warranted, we performed a retrospective cohort study to test the association
between antiphospholipid antibodies and perinatal outcome in this group of women.
The primary outcome we compared was adverse perinatal outcome, defined as delivery
<37 weeks' gestation secondary to maternal or fetal indications, intrauterine or neonatal
death, birth weight <10th percentile for gestational age, early-onset severe preeclampsia,
or placental abruption. Our sample size allowed for the detection of a 60% reduction
in the relative risk of adverse perinatal outcome in patients who were antiphospholipid
antibody screen negative (80% power, P = 0.05). No increased risk of adverse perinatal outcome was demonstrated among patients
with positive serum antiphospholipid antibodies (33.3%, 5/15) versus patients with
negative screening (40.0%, 22/55) in our cohort (RR 0.88, 95% Cl 0.38-1.83). Furthermore, antiphospholipid antibody status was not associated with
adverse perinatal outcome after controlling for classic indications for antibody screening
(RR
MH 0.63, 95% Cl 0.30-1.33). In conclusion, chronic hypertension patients with positive
antiphospholipid antibody screening are not at increased risk for adverse perinatal
outcome compared to those with negative screening. Therefore, screening for antiphospholipid
antibodies in chronic hypertension patients without classic indications for screening
is not warranted.
Keywords
Chronic hypertension - antiphospholipid antibodies - lupus anticoagulant - anticardiolipin
antibodies
