Obstetric antiphospholipid syndrome: early variations of angiogenic factors are associated with adverse outcomes

Cochery-Nouvellon, Éva; Mercier, É.; Bouvier, Sylvie; Balducchi, Jean-Pierre; Quéré, Isabelle; Perez-Martin, Antonia; Mousty, E.; Letouzey, V.; Gris, Jean‐Christophe

doi:10.3324/haematol.2016.155184

Cited by 11 publications

(6 citation statements)

References 32 publications

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“…Recent research [ 33 ] revealed a link between an imbalance in angiogenic factors and early-onset preeclampsia, characterized by elevated levels of soluble fms-like tyrosine kinase-1 and decreased placental growth factor. Abnormal PlGF-to-sFlt-1 ratio holds negative predictive value for adverse obstetric and neonatal outcomes in APS [ [34] , [35] , [36] ]. These findings support the investigation of angiogenesis-related biomarkers as a viable approach to detecting early-onset preeclampsia in patients with OAPS [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Obstetric antiphospholipid syndrome carries an increased lifetime risk for obstetric and thrombotic complications—a population-based study

Rhein,

Rabinovich,

Abuhasira

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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Section: Discussionmentioning

confidence: 99%

Obstetric antiphospholipid syndrome carries an increased lifetime risk for obstetric and thrombotic complications—a population-based study

Rhein,

Rabinovich,

Abuhasira

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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“…The NOH-ANGIO study, 43 an ancillary study to the NOH-APS, showed that the early LMWH-induced variations in placental growth factor and sFlt-1 concentrations in newly pregnant oAPS women may help to detect patients at a low risk of placental diseases, due to the high negative predictive value of their ratio of variations (0.92).…”

Section: Late Pregnancy Placental Diseasesmentioning

confidence: 99%

Antiphospholipid Antibodies in Pregnancy: Maternal and Neonatal Implications

Gris

Guillotin

Chéa

et al. 2022

Semin Thromb Hemost

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Antiphospholipid antibodies (aPL Abs) have long been associated with the occurrence of certain specific pregnancy morbidities, affecting both mother and fetus. Antithrombotic-based prophylactic regimens are the standard of care. Their intensity is modulated by the thrombotic history and has greatly improved the prognosis related to spontaneous morbidity. Observational studies show that this treatment is still associated with the persistence of excess of late-pregnancy placental diseases, calling for new or complementary developments, yet to be validated. Rigorous prospective multicentric validation of clinical and laboratory parameters capable of identifying those women and fetuses at a risk of pejorative evolution, thus early prognosis, is a priority issue. These will make it possible to develop customized treatments and test them. Furthermore, there are still concerns, particularly neurodevelopmental ones, about children born to aPL Ab-positive mothers, and clarification based on regular, more systematic evaluations is required. Even after pregnancy, women with a pure obstetrical antiphospholipid syndrome are at a greater risk of venous and arterial thrombosis over time, and prevention needs to be improved. These women also appear to develop more psychiatric and mood disorders. Central nervous system imaging using high-resolution techniques has shown subtle impairments in the white matter, associated with the most pathogenic aPL Abs and the clinical significance of this is under investigation. These mothers also seem to develop an excess of cancers. The systemic impact of aPL Abs is gradually being suspected, although this requires further evidence, and prevention should be envisaged.

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“…The use of complement inhibitors restored the balance and improved fetal outcomes 71 . Two studies concluded that an early assessment of PlGF:sFlt1 ratio could serve as biomarker, displaying good negative predictive values for severe pregnancy adverse events 72,73 …”

Section: Management Of Obstetric Aps: Whom and How Should We Treat?mentioning

confidence: 99%

Anti‐phospholipid antibodies and reproductive failures

Beltagy

Trespìdi

Gerosa

et al. 2020

American J Rep Immunol

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Anti‐phospholipid syndrome (APS) recapitulates the link between autoimmunity and pregnancy failure: Acquired anti‐phospholipid antibodies (aPL) play a pathogenic role in pregnancy complications. The diagnosis of obstetric APS can easily be pursued when women present with laboratory and clinical features fulfilling the international classification criteria. Standard therapeutic approach to obstetric APS consists in the association of anti‐platelet agents and anticoagulants. Most patients achieve a live birth thanks to conventional treatment; however, approximately 20% fail to respond and are managed with additional therapeutic tools added on the top of conventional treatment. Surely, a refinement of risk stratification tools would allow early identification of high‐risk pregnancies that warrant tailored treatment. In real life, obstetricians and rheumatologists face complex diagnostic scenarios including women with pregnancy morbidities other than those mentioned in classification criteria such as one or two early losses and premature birth after 34 weeks due to preeclampsia or placental insufficiency, women with low‐titer aPL not fulfilling criteria laboratory requirements, women with positive non‐criteria aPL, asymptomatic aPL carriers, and infertile women found to be aPL‐positive. This review focuses on some of the several unanswered questions related to diagnostic, prognostic, and therapeutic aspects in obstetric APS.

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Obstetric antiphospholipid syndrome: early variations of angiogenic factors are associated with adverse outcomes

Cited by 11 publications

References 32 publications

Obstetric antiphospholipid syndrome carries an increased lifetime risk for obstetric and thrombotic complications—a population-based study

Obstetric antiphospholipid syndrome carries an increased lifetime risk for obstetric and thrombotic complications—a population-based study

Antiphospholipid Antibodies in Pregnancy: Maternal and Neonatal Implications

Anti‐phospholipid antibodies and reproductive failures

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