Authors
Xueyang Zhang, Can Huang, Lingshan Liu, Yixin Cui, Bin Cai, Xiaohua Shi, Juntao Liu, Xinping Tian, Mengtao Li, Yijun Song, Xiaofeng Zeng, Jiuliang Zhao, Chinese Research Committee of Pregnancy and Reproduction in Autoimmune Rheumatic Diseases (CHOPARD)
Published in
RMD open. Volume 12. Issue 3. Jul 30, 2026. Epub Jul 30, 2026.
Abstract
Systemic lupus erythematosus (SLE) predominantly affects women of childbearing age and is often associated with adverse pregnancy outcomes (APOs). Antiphospholipid antibodies (aPLs) are known risk factors for APOs in the general population, and the prevalence of aPLs is higher in patients with SLE than healthy women.
This study aimed to investigate the impacts of aPLs and different aPLs profiles on pregnancy outcomes in patients with SLE.
This study analysed data from a single-centre SLE cohort in China. aPLs profiles, including anticardiolipin antibodies (aCL) IgG/IgM, anti-β2 glycoprotein I (anti-β2GPI) antibodies IgG/IgM and lupus anticoagulant (LA), were measured. APOs were defined as prefetal death, fetal death, pre-eclampsia with severe features occurring before 34 weeks of gestation and placental insufficiency with severe features occurring before 34 weeks of gestation.
The study comprised 441 singleton pregnancies occurring in 410 patients with SLE and 78 (17.9%) were positive for aPLs. Seventy-one (16.1%) patients developed APOs and 391 (88.7%) patients succeeded in giving a live birth. Patients with positive aPLs experienced APOs more frequently (29.5% vs 13.2%), with an OR of 2.56 (95% CI 1.38 to 4.65, p=0.002). aPLs were also associated with higher risks of fetal death (OR 3.87, 95% CI 1.17 to 12.19, p=0.021) and failure of live birth (OR 2.54, 95% CI 1.22 to 5.15, p=0.011). Analysis on the aPLs profiles revealed that aCL IgG (OR 3.02, 95% CI 1.44 to 6.15, p=0.003), anti-β2GPI IgG antibodies (OR 2.60, 95% CI 1.13 to 5.72, p=0.020) and LA (OR 2.85, 95% CI 1.44 to 5.56, p=0.002) increased the risks of APOs significantly, but aCL IgM and anti-β2GPI IgM antibodies did not. Further analysis demonstrated that LA plus IgG isotypes of aCL and/or anti-β2GPI antibodies was the highest-risk profile, increasing the incidences of APOs with an OR of 3.98 (95% CI 1.66 to 9.35, p=0.002), while the other combinations of aPLs positivity did not (OR 1.82, 95% CI 0.81 to 3.81, p=0.128).
This study demonstrated the adverse effects of aPLs in patients with SLE regarding the pregnancy outcomes, and different aPLs profiles displayed distinct impacts. This highlights the importance of risk stratification when managing pregnancy among patients with SLE, putting more focus on those with positive aPLs, especially those positive for LA plus IgG isotypes of aCL and/or anti-β2GPI antibodies.
PMID:
42532548
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.
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