Anti-Phosphatidylserine/Prothrombin Antibodies in Healthy Women with Unexplained Recurrent Pregnancy Loss

• Main Authors: Daniel E. Pleguezuelo, Oscar Cabrera-Marante, Magdalena Abad, Edgard Alfonso Rodriguez-Frias, Laura Naranjo, Alicia Vazquez, Olga Villar, Francisco Javier Gil-Etayo, Manuel Serrano, Alfredo Perez-Rivilla, Laura de la Fuente-Bitaine, Antonio Serrano
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Journal of Clinical Medicine
• Subjects: recurrent pregnancy loss; miscarriage; antiphospholipid syndrome; reproductive immunology; anti-phosphatidylserine/prothrombin; anticardiolipin
• Online Access: https://www.mdpi.com/2077-0383/10/10/2094

Recurrent pregnancy loss (RPL) affects up to 6% of couples. Although chromosomal aberrations of the embryos are considered the leading cause, 50% of cases remain unexplained. Antiphospholipid Syndrome is a known cause in a few cases. Antiphospholipid antibodies (aPL) anticardiolipin, anti-Beta-2-Glycoprotein-I and Lupus Anticoagulant (criteria aPL) are recommended studies in RPL workup. We tested healthy women with unexplained RPL for criteria aPL and anti-Phosphatidylserine/Prothrombin antibodies (aPS/PT). Patients were classified into three groups according to the number and pregnancy week of RPL: Extra-Criteria (EC), with 2 miscarriages, Early Miscarriage (EM), with ≥3 before pregnancy at week 10 and Fetal Loss (FL), with ≥1 fetal death from pregnancy at week 10. Circulating criteria aPL were absent in 98.1% of EM, 90.9% of FL and 96.6% of EC groups. In contrast, aPS/PT were positive in 15.4% of EM, 15.1% of FL, 16.6% of EC patients and 2.9% in controls. aPS/PT posed a risk for RPL, with an odds ratio of 5.96 (95% confidence interval (CI): 1.85–19.13. <i>p</i> = 0.002) for EM, 7.28 (95% CI: 2.07–25.56. <i>p</i> = 0.002) for FL and 6.56. (95% CI: 1.77–24.29. <i>p</i> = 0.004) for EC. A successful live birth was achieved in all pregnant patients positive for aPS/PT who received treatment with heparin, aspirin and/or hydroxychloroquine.