PDF(Pubmed)
Abstract：
UNASSIGNED: Antiphospholipid syndrome (APS) can present with either a thromboembolic event (thrombotic APS, TAPS) or an obstetric complication (obstetric APS, OAPS). Data on long-term complications in the different APS phenotypes are limited.
UNASSIGNED: We aimed to compare obstetric history, antiphospholipid antibody profiles, obstetric and thromboembolic complications, and pregnancy outcomes between TAPS and OAPS.
UNASSIGNED: This retrospective cohort study included women who delivered singleton pregnancies between 1998 and 2020. One hundred sixteen thousand four hundred nine women were included, resulting in 320,455 deliveries. Among the included patients, 71 were diagnosed with APS, 49 were classified as OAPS, and 22 as TAPS. The demographics, obstetric, neonatal, and thrombotic outcomes were compared among TAPS, OAPS, and the general obstetric population.
UNASSIGNED: OAPS patients had an increased risk of thrombotic events compared with the general obstetric population (odds ratio [OR] 18.0; 95% CI, 8.7-37.2). In pregnancies following the diagnosis of APS, despite standard antithrombotic treatment, OAPS patients exhibited an elevated risk of placenta-related and neonatal complications compared with the general obstetric population (late fetal loss [adjusted OR {aOR}, 15.3; 95% CI, 0.5-27.5], stillbirth [aOR, 5.9; 95% CI, 2.2-15.4], placental abruption [aOR, 4.8; 95% CI, 1.5-15.3], preeclampsia [aOR, 4.4; 95% CI, 2.5-7.7], fetal growth restriction [aOR, 4.3; 95% CI, 8.5-27.5], small for gestational age neonate [aOR, 4.0; 95% CI, 2.4-6.6], and low Apgar scores [Apgar\'1: aOR, 2.6; 95% CI, 1.3-10.4; Apgar\'5: aOR, 3.7; 95% CI, 1.3-10.4]). TAPS patients exhibited increased risk of preeclampsia (aOR, 3.1; 95% CI, 1.2-8).
UNASSIGNED: OAPS patients exhibit a heightened risk of thrombotic events compared with the general obstetric population. Despite treatment, OAPS and TAPS still presented obstetric complications. These findings, after confirmation in prospective studies, need to be taken into consideration when planning the treatment approach for these patients.
UNASSIGNED: We aimed to compare obstetric history, antiphospholipid antibody profiles, obstetric and thromboembolic complications, and pregnancy outcomes between TAPS and OAPS.
UNASSIGNED: This retrospective cohort study included women who delivered singleton pregnancies between 1998 and 2020. One hundred sixteen thousand four hundred nine women were included, resulting in 320,455 deliveries. Among the included patients, 71 were diagnosed with APS, 49 were classified as OAPS, and 22 as TAPS. The demographics, obstetric, neonatal, and thrombotic outcomes were compared among TAPS, OAPS, and the general obstetric population.
UNASSIGNED: OAPS patients had an increased risk of thrombotic events compared with the general obstetric population (odds ratio [OR] 18.0; 95% CI, 8.7-37.2). In pregnancies following the diagnosis of APS, despite standard antithrombotic treatment, OAPS patients exhibited an elevated risk of placenta-related and neonatal complications compared with the general obstetric population (late fetal loss [adjusted OR {aOR}, 15.3; 95% CI, 0.5-27.5], stillbirth [aOR, 5.9; 95% CI, 2.2-15.4], placental abruption [aOR, 4.8; 95% CI, 1.5-15.3], preeclampsia [aOR, 4.4; 95% CI, 2.5-7.7], fetal growth restriction [aOR, 4.3; 95% CI, 8.5-27.5], small for gestational age neonate [aOR, 4.0; 95% CI, 2.4-6.6], and low Apgar scores [Apgar\'1: aOR, 2.6; 95% CI, 1.3-10.4; Apgar\'5: aOR, 3.7; 95% CI, 1.3-10.4]). TAPS patients exhibited increased risk of preeclampsia (aOR, 3.1; 95% CI, 1.2-8).
UNASSIGNED: OAPS patients exhibit a heightened risk of thrombotic events compared with the general obstetric population. Despite treatment, OAPS and TAPS still presented obstetric complications. These findings, after confirmation in prospective studies, need to be taken into consideration when planning the treatment approach for these patients.
摘要：
■抗磷脂综合征（APS）可出现血栓栓塞事件（血栓性APS，TAPS）或产科并发症（产科APS，OAPS)。关于不同APS表型的长期并发症的数据是有限的。
■我们的目的是比较产科病史，抗磷脂抗体谱，产科和血栓栓塞并发症，TAPS和OAPS之间的妊娠结局。
这项回顾性队列研究纳入了1998年至2020年单胎妊娠的女性。其中包括十万一万六千四百九名妇女，导致320,455次交付。在纳入的患者中，71人被诊断患有APS，49人被归类为OAPS，和22作为TAPS。人口统计，产科,新生儿,和血栓结局在TAPS之间进行了比较，OAPS,和一般产科人群。
■OAPS患者与普通产科人群相比，发生血栓事件的风险增加（比值比[OR]18.0；95%CI，8.7-37.2）。在APS诊断后的怀孕中，尽管有标准的抗血栓治疗,与一般产科人群相比，OAPS患者出现胎盘相关并发症和新生儿并发症的风险升高（晚期胎儿丢失[校正OR{aOR}，15.3；95%CI，0.5-27.5]，死产[，5.9；95%CI，2.2-15.4]，胎盘早剥[，4.8；95%CI，1.5-15.3]，先兆子痫[aOR，4.4；95%CI，2.5-7.7]，胎儿生长受限[aOR，4.3；95%CI，8.5-27.5]，小于胎龄新生儿[aOR，4.0；95%CI，2.4-6.6]，和低阿普加分数[阿普加1:aOR，2.6；95%CI，1.3-10.4；Apgar\'5：aOR，3.7；95%CI，1.3-10.4]）。TAPS患者表现出先兆子痫的风险增加(aOR，3.1；95%CI，1.2-8）。
■OAPS患者与一般产科人群相比，出现血栓事件的风险增加。尽管治疗,OAPS和TAPS仍然存在产科并发症。这些发现,经过前瞻性研究的确认，在计划这些患者的治疗方法时需要考虑。
■我们的目的是比较产科病史，抗磷脂抗体谱，产科和血栓栓塞并发症，TAPS和OAPS之间的妊娠结局。
这项回顾性队列研究纳入了1998年至2020年单胎妊娠的女性。其中包括十万一万六千四百九名妇女，导致320,455次交付。在纳入的患者中，71人被诊断患有APS，49人被归类为OAPS，和22作为TAPS。人口统计，产科,新生儿,和血栓结局在TAPS之间进行了比较，OAPS,和一般产科人群。
■OAPS患者与普通产科人群相比，发生血栓事件的风险增加（比值比[OR]18.0；95%CI，8.7-37.2）。在APS诊断后的怀孕中，尽管有标准的抗血栓治疗,与一般产科人群相比，OAPS患者出现胎盘相关并发症和新生儿并发症的风险升高（晚期胎儿丢失[校正OR{aOR}，15.3；95%CI，0.5-27.5]，死产[，5.9；95%CI，2.2-15.4]，胎盘早剥[，4.8；95%CI，1.5-15.3]，先兆子痫[aOR，4.4；95%CI，2.5-7.7]，胎儿生长受限[aOR，4.3；95%CI，8.5-27.5]，小于胎龄新生儿[aOR，4.0；95%CI，2.4-6.6]，和低阿普加分数[阿普加1:aOR，2.6；95%CI，1.3-10.4；Apgar\'5：aOR，3.7；95%CI，1.3-10.4]）。TAPS患者表现出先兆子痫的风险增加(aOR，3.1；95%CI，1.2-8）。
■OAPS患者与一般产科人群相比，出现血栓事件的风险增加。尽管治疗,OAPS和TAPS仍然存在产科并发症。这些发现,经过前瞻性研究的确认，在计划这些患者的治疗方法时需要考虑。
