Publication:

A comparative study of antiphospholipid antibodies in preeclampsia and normotensive pregnant women

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).