Pregnancy Outcomes in Grand Multiparity Women With Antiphospholipid Antibodies.
antiphospholipid syndrome
grand multiparity
pregnancy outcome
Journal
American journal of reproductive immunology (New York, N.Y. : 1989)
ISSN: 1600-0897
Titre abrégé: Am J Reprod Immunol
Pays: Denmark
ID NLM: 8912860
Informations de publication
Date de publication:
Nov 2024
Nov 2024
Historique:
received:
20
07
2024
accepted:
16
10
2024
medline:
31
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
ppublish
Résumé
In recent years antiphospholipid syndrome (APS) as well as antiphospholipid antibodies (aPL) prevalence has demonstrated an upward trend in women during reproductive age. There is a lack of data concerning its effects on women with grand multiparity (GMP) (parity ≥5). Hence, this study aimed to assess pregnancy outcomes among GMP aPL/APS patients. We retrospectively assembled the births of GMP women with aPL/APS, between 2017 and 2022 in the Sheba Medical Center. We compared their deliveries with those of two control groups: (1) the "aPL/APS-controls"-of pregnant women with aPL/APS and parity <5. (2) The "GMP-controls"- parity ≥5 without aPL/APS. We examined demographics, aPL characteristics, pregnancy, and neonatal outcomes between the groups. In total, 42 deliveries in the study group were compared to 461 deliveries in the "aPL/APS-controls" group and 84 deliveries of the "GMP-controls." Most parameters were similar across groups. However, the study group had a higher rate of obstetric APS diagnosis (64.64% vs. 83.33%, p < 0.01) and showed significant differences such as older maternal age, higher BMI, more polyhydramnios cases, and larger babies compared to controls (33.91 vs. 36.19, p = 0.05; 23.2 vs. 28.89, p = 0.02; 3.68 vs. 11.9, p = 0.01; and 2.17 vs. 14.28, p < 0.01, respectively). Our findings reveal that perinatal outcomes in aPL/APS GMP women are comparable and not inferior to those in aPL/APS women with <5 pregnancies or in comparison to the general GMP population. The minor differences observed may all be related to GMP women's older age and higher BMI.
Substances chimiques
Antibodies, Antiphospholipid
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e70013Informations de copyright
© 2024 The Author(s). American Journal of Reproductive Immunology published by John Wiley & Sons Ltd.
Références
A. H. Mgaya, S. N. Massawe, H. L. Kidanto, and H. N. Mgaya, Grand Multiparity: Is It Still a Risk in Pregnancy? [Internet]. (2013), http://www.biomedcentral.com/1471‐2393/13/241.
T. T. Dasa, M. A. Okunlola, and Y. Dessie, “Effect of Grand Multiparity on Adverse Maternal Outcomes: A Prospective Cohort Study,” Frontiers in Public Health 10 (2022): 959633.
T. T. Dasa, M. A. Okunlola, and Y. Dessie, “Effect of Grand Multiparity on the Adverse Birth Outcome: A Hospital‐Based Prospective Cohort Study in Sidama Region, Ethiopia,” International Journal of Women's Health 14 (2022): 363–372.
S. M. Shahida, M. A. Islam, S. Begum, M. A. Hossain, and M. S. Azam, “Maternal Outcome of Grand Multipara,” Mymensingh Medical Journal 20, no. 3 (2011): 381–385.
M. H. Alhainiah, H. S. O. Abdulljabbar, and Y. A. Bukhari, “The Prevalence, the Fetal and Maternal Outcomes in Grand Multiparas Women,” Materia Socio‐Medica 30, no. 2 (2018): 118–120.
H. Roman, P. Y. Robillard, E. Verspyck, T. C. Hulsey, L. Marpeau, and G. Barau, “Obstetric and Neonatal Outcomes in Grand Multiparity,” Obstetrics and Gynecology 103, no. 6 (2004): 1294–1299.
K. E. Lee, T. Wen, A. S. Faye, Y. Huang, C. Hur, and A. M. Friedman, “Delivery Risks and Outcomes Associated With Grand Multiparity,” Journal of Maternal‐Fetal and Neonatal Medicine 35, no. 25 (2022): 7708–7716.
R. Rayamajhi, M. Thapa, and S. Pande, “The Challenge of Grandmultiparity in Obstetric Practice,” Kathmandu University Medical Journal (KUMJ) 4, no. 1 (2006): 70–74.
Y. Başkiran, K. Uçkan, and İ. Çeleğen, “Effect of Grand Multiparity on Maternal, Obstetric, Fetal and Neonatal Results,” European Review for Medical & Pharmacological Sciences 27, no. 22 (2023).
P. R. Vaswani and S. Sabharwal, “Trends in the Occurrence of Antenatal and Perinatal Complications With Increasing Parity,” Journal of Obstetrics and Gynecology of India 63, no. 4 (2013): 260–267.
H. Alkwai, F. Khan, R. Alshammari, et al., “The Association Between Grand Multiparity and Adverse Neonatal Outcomes: A Retrospective Cohort Study From Ha'il, Saudi Arabia,” Children 10, no. 9 (2023).
M. A. Alsammani, A. M. Jafer, S. A. Khieri, A. O. Ali, and M. A. Shaaeldin, “Effect of Grand Multiparity on Pregnancy Outcomes in Women Under 35 Years of Age: A Comparative Study,” Medical Archives 73, no. 2 (2019): 92–96.
G. K. Al‐Shaikh, G. H. Ibrahim, A. A. Fayed, and H. Al‐Mandeel, “Grand Multiparity and the Possible Risk of Adverse Maternal and Neonatal Outcomes: A Dilemma to be Deciphered,” BMC Pregnancy Childbirth 17, no. 1 (2017): 310.
A. A. Odukogbe, I. F. Adewole, O. A. Ojengbede, et al., “Grandmultiparity—Trends and Complications: A Study in Two Hospital Settings,” Journal of Obstetrics and Gynaecology (Lahore) 21, no. 4 (2001): 361–367.
C. A. DeBolt, M. G. Rao, M. A. Limaye, et al., “Grand Multiparity and Obstetric Outcomes in a Contemporary Cohort: The Role of Increasing Parity,” American Journal of Perinatology 41, no. 07 (2023): 815–825.
J. Alijotas‐Reig, R. Ferrer‐Oliveras, A. Ruffatti, et al., “The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A Survey of 247 Consecutive Cases,” Autoimmunity Reviews 14, no. 5 (2015): 387–395.
Z. B. Erton, E. Sevim, G. R. de Jesús, et al., “Pregnancy Outcomes in Antiphospholipid Antibody Positive Patients: Prospective Results From the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (‘Registry’),” Lupus Science & Medicine 9, no. 1 (2022): e000633.
D. W. Branch and M. A. Khamashta, “Antiphospholipid Syndrome: Obstetric Diagnosis, Management, and Controversies,” Obstetrics and Gynecology 101 (2003): 1333.
D. Erkan, “The Relation Between Antiphospholipid Syndrome‐Related Pregnancy Morbidity and Non‐Gravid Vascular Thrombosis: A Review of the Literature and Management Strategies,” Current Rheumatology Reports 4, no. 5 (2002): 379–386.
G. R. de Jesús, G. Rodrigues, N. R. de Jesús, and R. A. Levy, “Pregnancy Morbidity in Antiphospholipid Syndrome: What Is the Impact of Treatment?,” Current Rheumatology Reports 16, no. 2 (2014): 403.
S. Miyakis, M. D. Lockshin, T. Atsumi, et al., “International Consensus Statement on an Update of the Classification Criteria for Definite Antiphospholipid Syndrome (APS),” Journal of Thrombosis and Haemostasis 4, no. 2 (2006): 295–306.
I. Bautista‐Castaño, P. Henriquez‐Sanchez, N. Alemán‐Perez, et al., “Maternal Obesity in Early Pregnancy and Risk of Adverse Outcomes,” PLoS ONE 8, no. 11 (2013): e80410, https://doi.org/10.1371/journal.pone.0080410.
W. A. Wilson, A. E. Gharavi, T. Koike, et al., “International Consensus Statement on Preliminary Classification Criteria for Definite Antiphospholipid Syndrome: Report of an International Workshop,” Arthritis and Rheumatism 42, no. 7 (1999): 1309–1311.
M. Barbhaiya, S. Zuily, R. Naden, et al., “2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria,” Annals of the Rheumatic Diseases 82, no. 10 (2023): 1258–1270.
C. M. Yelnik, C. A. Laskin, T. F. Porter, et al., “Lupus Anticoagulant Is the Main Predictor of Adverse Pregnancy Outcomes in aPL‐positive Patients: Validation of PROMISSE Study Results,” Lupus Science & Medicine 3, no. 1 (2016): e000131.
G. Saccone, V. Berghella, G. M. Maruotti, et al., “Antiphospholipid Antibody Profile Based Obstetric Outcomes of Primary Antiphospholipid Syndrome: The PREGNANTS Study,” American Journal of Obstetrics and Gynecology 216, no. 5 (2017): 525.e1–525.e12.
I. J. Walter, M. J. Klein Haneveld, A. T. Lely, K. W. M. Bloemenkamp, M. Limper, and J. Kooiman, “Pregnancy Outcome Predictors in Antiphospholipid Syndrome: A Systematic Review and Meta‐Analysis,” Autoimmunity Reviews 20, no. 10 (2021): 102901.
A. Ruffatti, M. Favaro, A. Calligaro, A. Zambon, and T. Del Ross, “Management of Pregnant Women With Antiphospholipid Antibodies,” Expert Review of Clinical Immunology 15, no. 4 (2019): 347–358.
M. G. Tektonidou, L. Andreoli, M. Limper, et al., “EULAR Recommendations for the Management of Antiphospholipid Syndrome in Adults,” Annals of the Rheumatic Diseases 78, no. 10 (2019): 1296–1304.