A comparative study of antiphospholipid antibodies in preeclampsia and normotensive pregnant women
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253323Keywords:
Cephalohematoma, Instrument assisted vaginal deliveriesAbstract
Background: Hypertensive disorders of pregnancy cause major portion of maternal morbidity, mortality and poor feto maternal outcome. Abnormal trophoblastic invasion changes are seen in placental development in preeclamptic mother. Preeclampsia harms mother and baby, causing complications like intrauterine fetal death (IUFD), fetal growth restriction (FGR), and preterm delivery. Antiphospholipid antibodies (APLA) trigger coagulation, complement activation, and impaired syncytiotrophoblast differentiation, contributing to preeclampsia development. The study compared Antiphospholipid antibodies (anti-β2GPI, anticardiolipin, lupus anticoagulant) in preeclampsia and normotensive pregnancies. Detecting APLA may help predict preeclampsia and guide timely, specific management for at-risk women.
Method: The present study was conducted in Hindu Rao Hospital, New Delhi from January 2021 to May 2022. It was an observational case-control study which involved 100 normotensive pregnant women and 100 preeclamptic women who met the inclusion criteria. Blood pressure was measured in sitting position, and women were classified as preeclamptic or normotensive. Antiphospholipid antibodies were tested by enzyme linked immunosorbent assay (ELISA) and analyzed in the Biochemistry department. The following tests, anticardiolipin antibodies (aCL)-IgM and IgG, anti-beta-2 glycoprotein-IgM and IgG B and dilute Russell's viper venom time (DRVVT) screened lupus anticoagulant were done; presence of any antibody was positive, outcomes compared.
Results: In this study, out of 100 preeclamptic patients, 20 were positive for APLA antibodies (9 were positive among non-severe preeclampsia and 11were positive among severe preeclampsia) and out of 100 normotensive pregnant women, 3 were positive for APLA antibodies. Receiver operating characteristic (ROC) analysis showed lupus anticoagulant had 93% sensitivity and 97% specificity. APLA positivity was linked to preeclampsia, FGR, preterm delivery, lower segment caesarean section (LSCS), and neonatal complications.
Conclusions: The study found APLA prevalence of 20% in preeclamptic (9% non-severe, 11% severe) and 3% in normotensive women. Anticardiolipin and lupus anticoagulant differed significantly (p<0.05), but anti-β2GPI showed no significant difference (p>0.05).
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References
The American College of Obstetrics and Gynaecologists. Preeclampsia: ACOG practice bulletin, number 222. Obstet Gynecol. 2020;135(6):e237-60. DOI: https://doi.org/10.1097/AOG.0000000000003891
Svenungsson E, Antovic A. The antiphospholipid syndrome–often overlooked cause of vascular occlusions? J Intern Med. 2020;287(4):349-72. DOI: https://doi.org/10.1111/joim.13022
Kumar P, Srivastava S, Chauhan S, Patel R, Marbaniang SP, Dhillon P. Factors associated with gynaecological morbidities and treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India. PLoS One. 2021;16(6):e0252521. DOI: https://doi.org/10.1371/journal.pone.0252521
Qi X, Liu Y, Wang J, Fallowfield JA, Wang J, Li X, et al. Clinical course and risk factors for mortality of COVID-19 patients with pre-existing cirrhosis: a multicentre cohort study. Gut. 2021;70(2):433-6.
Jethani S, Singh SK, Kamble BD, Dobhal V, Singh S, Jha D, et al. Epidemiological pattern and trend analysis of animal bite cases of anti-rabies clinic of tertiary care hospital of Delhi. J Fam Med Prim Care. 2022;11(2):728-32. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1395_21
Li J, Somers VK, Gao X, Chen Z, Ju J, Lin Q, et al. Evaluation of optimal diastolic blood pressure range among adults with treated systolic blood pressure less than 130 mm Hg. JAMA Netw Open. 2021;4(2):e2037554. DOI: https://doi.org/10.1001/jamanetworkopen.2020.37554
Pamu DPK. Lupus anti-coagulant (LA) screening & confirmation testing by dilute Russell viper venom time (DRVVT) method. Int J Clin Diagn Pathol. 2020;3(4):12-5. DOI: https://doi.org/10.33545/pathol.2020.v3.i4a.305
Ayub F, Talib M, Iqbal MA. Association between Antiphospholipid Antibodies (APLA) and Preeclampsia (PE) in Females Presenting for Antenatal Check-Up. 2022. Available at: https://ijcsrr. org/wp-content/uploads/2022/06/30-18-2022.pdf. Accessed on 21 August 2025.
Panigrahi S, Tripathy SR, Padhi M, Tripathy R, Das BK. Prevalence of Antiphospholipid Antibodies in Patients with Bad Obstetric History of unknown Etiology and Its Association with Clinical Parameters. J South Asian Fed Obstet Gynaecol. 2022;14(5):514-8. DOI: https://doi.org/10.5005/jp-journals-10006-2118
Kaur G, Pahwa S, Kaur A, Nagpal M. A comparative study of the serum levels of antiphospholipid antibodies in hypertensive disorder of pregnancy and normotensive pregnancy. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):580-5. DOI: https://doi.org/10.18203/2320-1770.ijrcog20170386
Awodu OA, Shokunbi WA, Ejele OA. Lupus anticoagulant in Nigerian women with preeclampsia. West Afr J Med. 2003;22(3):240-2. DOI: https://doi.org/10.4314/wajm.v22i3.27958
Hussain K, Gauto-Mariotti E, Cattoni HM, Arif AW, Richardson C, Manadan A, et al. A meta-analysis and systematic review of valvular heart disease in systemic lupus erythematosus and its association with antiphospholipid antibodies. J Clin Rheumatol. 2021;27(8):e525-32. DOI: https://doi.org/10.1097/RHU.0000000000001464
Zemet R, Dulitzki M, Baum M, Friedman HO, Morag I, Simchen MJ. Early-onset preeclampsia–The impact of antiphospholipid antibodies on disease severity. Eur J Obstet Gynecol Reprod Biol. 2021;263:79-84. DOI: https://doi.org/10.1016/j.ejogrb.2021.06.006
Smith J, Johnson A, Lee R. Advancements in AI research. J Artif Intell. 2025;10(2):123-35.
Ferreira DS, Comar SR. Evaluation of mixing tests and the index of circulating anticoagulant in detecting lupus anticoagulants. J Bras Patol Med Lab. 2021;57:1-11. DOI: https://doi.org/10.5935/1676-2444.20210053
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