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Risk of thromboembolic events after recurrent spontaneous abortion in antiphospholipid syndrome: a case–control study
  1. Maria Angeles Martinez-Zamora1,
  2. Sara Peralta1,
  3. Montserrat Creus1,
  4. Dolors Tassies2,
  5. Juan Carlos Reverter2,
  6. Gerard Espinosa3,
  7. Ricard Cervera3,
  8. Francisco Carmona1,
  9. Juan Balasch1
  1. 1Institut Clínic of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, University of Barcelona, Hospital Clínic – Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
  2. 2Service of Hemotherapy and Hemostasis, Faculty of Medicine, University of Barcelona, Hospital Clínic – Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
  3. 3Service of Autoimmune Diseases, Faculty of Medicine, University of Barcelona, Hospital Clínic – Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
  1. Correspondence to Juan Balasch, Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic, Villarroel, 170. 08 Barcelona, Spain; jbalasch{at}ub.edu

Abstract

Objective To investigate whether patients having antiphospholipid syndrome (APS) as the only aetiological factor for recurrent spontaneous abortion (RSA) are at increased risk of thrombosis later in life.

Methods A case–control study at a tertiary university referral centre. The study group consisted of 57 primary APS and RSA women (APS–RSA group). Control groups included: 86 patients with RSA of unknown aetiology (uRSA group), 42 patients with RSA and thrombophilic genetic defects as the only aetiologic factor for RSA (tRSA group) and 30 antiphospholipid antibody (aPL) positive but otherwise healthy women (aPL group). The main measurement was the thrombosis rate after long-term follow-up.

Results APS–RSA patients had a significantly higher 12-year cumulative thrombotic incidence rate compared with the three comparator groups (19.3% vs 4.8%, 0.0% and 0.0%, respectively (log rank), p<0.001). Patients in the APS–RSA group had 25.6 thrombotic events per 1000 patient-years (95% CI 12.8 to 45.9). The OR of thrombosis in relation to the presence (APS–RSA group) or absence (uRSA and tRSA groups) of aPL in patients with RSA was 15.06 (95% CI 3.2 to 70.5).

Conclusions Our data indicate that a history of RSA associated with aPL is a risk factor for subsequent thrombosis in the long term.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the ethics committee of the Hospital Clinic of Barcelona.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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