PREECLAMPSIA AND FETAL GROWTH-RETARDATION - IS THERE AN ASSOCIATION WITH ANTIPHOSPHOLIPID ANTIBODIES

Objective: To examine the association between antiphospholipid antibod ies and preeclampsia/fetal growth retardation. Methods: In this prospe ctive, observational study, six tests for antiphospholipid antibodies (IgG and IgM anticardiolipin and anticephalin antibody enzyme-linked i mmunosorbent assays, activated partial thromboplastin time and Russell 's viper venom time-based clotting tests) were performed on plasma fro m 200 unselected women with preeclampsia (145 cases of mild and 55 cas es of severe preeclampsia) and 97 normotensive pregnant women of match ed gestational age. Main Outcome Measures: Prevalence of antiphospholi pid antibodies in preeclamptic women and controls, and the association between these autoantibodies and fetal growth retardation. Results: T he IgG anticephalin antibody test and the activated partial thrombopla stin time-based test for lupus anticoagulants were both positive in a significantly higher proportion of preeclamptic women (10.5% and 11.5% , respectively) than in controls (3.1% for both tests, P = 0.03 and 0. 02, respectively). In the IgG anticardiolipin antibody test, 7.3% of t hose with severe preeclampsia and 1.0% of the control women were posit ive (P = 0.04). Five out of six patients with the HELLP syndrome were antiphospholipid antibody positive. No association was found between t he presence of antiphospholipid antibodies and fetal growth retardatio n. Conclusion: The proportion of antiphospholipid antibodies was somew hat higher in preeclamptic than in normotensive pregnant women, but th ese antibodies were not associated with fetal growth retardation. An a ssociation between antiphospholipid antibodies and the HELLP syndrome is suggested.