Anti-phospholipid antibodies in women presenting with preterm delivery related to preeclampsia or placental insufficiency.

Objectives To assess the proportion of antiphospholipid antibodies in women presenting with preterm delivery related to preeclampsia or placental insufficiency. Material and Methods This was a prospective cohort study conducted at Department of Gynaecology and obstetrics. Women aged 20 -40 years with preeclampsia who delivered before 34 weeks were included as cases. Women who delivered before 34 weeks but did not have preeclampsia were included as controls. Both had estimation of antiphospholipid antibodies at diagnosis and 12 weeks postnatally. Women were diagnosed with antiphospholipid antibody syndrome as per Sapporo's criteria. Results During the study period 98 cases and 106 Controls were included. Both cases and controls were similar in terms of age, gestational age and parity. Among the study population 17.3% cases had Antiphospholipid antibodies as compared to 3.8% controls (p=0.001). Cases were more likely to be Balochs (34.7% vs. 11.3%, p= 0.001), have a history of miscarriage (25.5% vs. 13.2%, p=0.026), using aspirin (p˂0.001), low molecular weight heparin (p˂0.001), and were obese (p˂0.001) than controls. Cases that were more likely to have Lupus anticoagulant antibodies LAC (82.4% vs. 75%, p=0.002) whereas controls were more likely to have anti cardiolipin antibodies. (50% vs. 47%, p= 0.003). Conclusion Our study confirms a high prevalence of antiphospholipid antibodies in women who have preterm delivery due to preeclampsia or placental insufficiency. An opportunity to screen these women should not be missed, so that proper counselling can be done and future pregnancies can be managed in an appropriate and timely manner.