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Abstract
Women with antiphospholipid syndrome (APS) have pregnancies complicated by placentally-mediated events whereas women with antiphospholipid antibodies (aPL) have similar pregnancy outcomes to the normal population. Low PAPP-A concentrations are useful in predicting adverse pregnancy outcomes in the general population. We aimed to determine whether PAPP-A concentrations could identify women with APS at risk of adverse outcomes.
Methods This retrospective case control study included all women with singleton pregnancies (without fetal anomalies) with persistent aPL and PAPP-A concentrations between 2008 and 2012. The women were grouped as those fulfilling the classification criteria for APS and those who had persistent aPL without a history of thrombosis or adverse pregnancy outcomes. Data obtained included demographic details, medical comorbidities, aPL subtypes, nicotine use. Pregnancy outcomes included live birth, miscarriages > 10 weeks, pre-eclampsia, abruption, birthweight.
Results Sixty-one cases were identified. There were no significant differences in maternal baseline characteristics. Live birth rates were similar between both groups. There were significant differences (p < 0.05) between all placentally-mediated complications, birthweight and customised birthweight centiles. However, despite these complications, PAPP-A concentrations were similar. There was no trend towards adverse outcomes with lower PAPP-A concentrations.
Conclusion Despite the high rate of placentally-mediated complications in women with APS, a low PAPP-A was not useful in predicting these complications.