ß2-Glycoprotein I Dependent Anticardiolipin Antibodies and Lupus Anticoagulant in Patients With Recurrent Pregnancy Loss

AIM: The present study was aimed to define the incidence of antiphospholipid antibodies of different types lupus anticoagulant (LAC), venereal disease research laboratory test (VDRL) and ß₂-glycoprotein I dependent anticardiolipin antibodies (ß₂ I aCL) in our cohort of population experiencing recurrent pregnancy loss (RPL) from Andhra Pradesh, South India. SETTING AND DESIGN: A referral case-control study at a tertiary centre over a period of 5 years. PARTICIPANTS: 150 couples experiencing 3 or more recurrent pregnancy losses with similar number of matched controls. MATERIAL AND METHODS: LAC activity was measured by the activated partial thromboplastin time (aPTT) according to the method of Proctor and Rapaport with relevant modifications. VDRL analysis was performed by the kit method supplied by Ranbaxy Diagnostics Limited and ß₂ Glycoprotein I dependant anticardiolipin antibodies were estimated by ELISA kit (ORGen Tech, GmbH, Germany) with human ß₂ Glycoprotein I as co-factor. STATISTICAL ANALYSIS: Statistical analysis was performed using Student's t test. RESULTS: LAC activity was found positive in 11 women (10.28%). The mean ± SE ß₂ I aCL concentration in the study group was 14.53 (u/ml) ± 1.79 (range 0 to 90.4 u/ml) which was higher than the control group with a mean ± SE of 7.26 (u/ml) ± 0.40 (range 0 to 18 u/ml). The binding of the antibodies to the antigen was observed in 40.24% (n=33) of the cases compared to 6.09% (n=5) in controls. VDRL test was positive in 7(2.34%) individuals (3 couples and 1 male partner) and none among controls. CONCLUSIONS: The present study indicates the importance of antiphospholipid antibodies in women experiencing RPL and suggests the usefulness of screening for these antibodies as a mandatory routine for instituting efficient therapeutic regimens for a successful outcome of pregnancy.

Keywords
Antiphospholipid antibodies, Antiphospholipid syndrome, ß2-glycoprotein I dependent anticardiolipin antibodies, Lupus anticoagulant, Recurrent pregnancy loss.