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Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes

BACKGROUND: Bleeding complications are recognized as relatively infrequent manifestations of antiphospholipid syndrome (APS), and the safety of antithrombotic therapy during pregnancy is of concern. This study aims to assess the risk factors and possible associations between bleeding complications a...

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Autores principales: Luo, Yongjing, Jin, Jiayang, Yan, Yani, Zhang, Mengyao, Hou, Lei, Hou, Yuke, Pei, Qiuyan, Li, Chun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10064047/
https://www.ncbi.nlm.nih.gov/pubmed/37006292
http://dx.doi.org/10.3389/fimmu.2023.1145146
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author Luo, Yongjing
Jin, Jiayang
Yan, Yani
Zhang, Mengyao
Hou, Lei
Hou, Yuke
Pei, Qiuyan
Li, Chun
author_facet Luo, Yongjing
Jin, Jiayang
Yan, Yani
Zhang, Mengyao
Hou, Lei
Hou, Yuke
Pei, Qiuyan
Li, Chun
author_sort Luo, Yongjing
collection PubMed
description BACKGROUND: Bleeding complications are recognized as relatively infrequent manifestations of antiphospholipid syndrome (APS), and the safety of antithrombotic therapy during pregnancy is of concern. This study aims to assess the risk factors and possible associations between bleeding complications and adverse pregnancy outcomes (APOs) in patients with APS. METHODS: A retrospective cohort study was conducted at the Peking University People’s Hospital. The clinical and immunologic features, bleeding complications, treatment, and pregnancy outcomes of patients with APS were collected. Univariate and multivariate logistic regression analyses were applied to assess the associations between APOs and bleeding complications. RESULTS: A total of 176 participants with obstetric APS were included in the analysis. There were 66 (37.50%) patients with APS with hemorrhage complications and 86 (48.86%) patients with APS with APOs. Mucocutaneous hemorrhage was associated with APOs including fetal death after 12 weeks [odds ratio (OR) = 10.73, 95% confidence interval (CI): 1.61–71.74, p = 0.014], preterm delivery prior to 34 weeks (OR = 8.30, 95% CI: 2.31–29.84, p = 0.001), and small for gestational age (OR = 4.17, 95% CI: 1.22–14.21, p = 0.023) in univariate logistic regression analyses. It also independently associated with preterm delivery prior to 34 weeks (OR = 40.29, 95% CI: 1.45–1121.32, p = 0.030) in multivariate logistic regression analyses. Receiver operating characteristic (ROC) analysis evaluating the accuracy of these factors for preterm delivery prior to 34 weeks showed that the area under ROC curve was 0.871. CONCLUSION: The study shows that mucocutaneous hemorrhage may be an indication of the occurrence of APOs in obstetric patients with APS.
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spelling pubmed-100640472023-04-01 Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes Luo, Yongjing Jin, Jiayang Yan, Yani Zhang, Mengyao Hou, Lei Hou, Yuke Pei, Qiuyan Li, Chun Front Immunol Immunology BACKGROUND: Bleeding complications are recognized as relatively infrequent manifestations of antiphospholipid syndrome (APS), and the safety of antithrombotic therapy during pregnancy is of concern. This study aims to assess the risk factors and possible associations between bleeding complications and adverse pregnancy outcomes (APOs) in patients with APS. METHODS: A retrospective cohort study was conducted at the Peking University People’s Hospital. The clinical and immunologic features, bleeding complications, treatment, and pregnancy outcomes of patients with APS were collected. Univariate and multivariate logistic regression analyses were applied to assess the associations between APOs and bleeding complications. RESULTS: A total of 176 participants with obstetric APS were included in the analysis. There were 66 (37.50%) patients with APS with hemorrhage complications and 86 (48.86%) patients with APS with APOs. Mucocutaneous hemorrhage was associated with APOs including fetal death after 12 weeks [odds ratio (OR) = 10.73, 95% confidence interval (CI): 1.61–71.74, p = 0.014], preterm delivery prior to 34 weeks (OR = 8.30, 95% CI: 2.31–29.84, p = 0.001), and small for gestational age (OR = 4.17, 95% CI: 1.22–14.21, p = 0.023) in univariate logistic regression analyses. It also independently associated with preterm delivery prior to 34 weeks (OR = 40.29, 95% CI: 1.45–1121.32, p = 0.030) in multivariate logistic regression analyses. Receiver operating characteristic (ROC) analysis evaluating the accuracy of these factors for preterm delivery prior to 34 weeks showed that the area under ROC curve was 0.871. CONCLUSION: The study shows that mucocutaneous hemorrhage may be an indication of the occurrence of APOs in obstetric patients with APS. Frontiers Media S.A. 2023-03-17 /pmc/articles/PMC10064047/ /pubmed/37006292 http://dx.doi.org/10.3389/fimmu.2023.1145146 Text en Copyright © 2023 Luo, Jin, Yan, Zhang, Hou, Hou, Pei and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Luo, Yongjing
Jin, Jiayang
Yan, Yani
Zhang, Mengyao
Hou, Lei
Hou, Yuke
Pei, Qiuyan
Li, Chun
Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes
title Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes
title_full Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes
title_fullStr Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes
title_full_unstemmed Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes
title_short Hemorrhage complications in obstetric antiphospholipid syndrome: Risk factors and association with adverse pregnancy outcomes
title_sort hemorrhage complications in obstetric antiphospholipid syndrome: risk factors and association with adverse pregnancy outcomes
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10064047/
https://www.ncbi.nlm.nih.gov/pubmed/37006292
http://dx.doi.org/10.3389/fimmu.2023.1145146
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