DOWN-REGULATION OF MATERNAL ANTIPHOSPHOLIPID ANTIBODIES DURING EARLY-PREGNANCY AND PREGNANCY OUTCOME

OBJECTIVE: We investigated the hypothesis that maternal autoimmune res ponses to phosphilipid antigens measured before and during pregnancy a re not related to successful pregnancy outcome. STUDY DESIGN: One hund red twenty-three women with recurrent spontaneous abortions were seria lly tested for antiphospholipid antibodies during their pregnancies. R ESULTS: In 72 women with recurrent spontaneous abortions and without a ntiphospholipid antibodies before the pregnancy, the incidence of anti phospholipid antibody production at the time of pregnancy termination was significantly higher in those who miscarried the index pregnancy t han those who were delivered of a live-born infant. In 51 antiphosphol ipid antibody-positive women with recurrent spontaneous abortions ther e were dramatic increases in titers of anticardiolipin antibody and an tiphosphatidylserine antibody in those who miscarried the index pregna ncy (p < 0.005). In women who were delivered of a live-born infant, th e titers remained stable or decreased during pregnancy. CONCLUSIONS: D own-regulation of antiphospholipid antibody production during early pr egnancy is associated with favorable pregnancy outcome.