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14TH INTERNATIONAL CONGRESS ON ANTIPHOSPHOLIPID ANTIBODIES TASK FORCE REPORT ON OBSTETRIC ANTIPHOSPHOLIPID SYNDROME
Author
Affilliation
Universidade do Estado do Rio de Janeiro. Departamento de Obstetrícia. Rio de Janeiro, RJ, Brasil
Sheba Medical Center. The Zabludowicz Center for Autoimmune Diseases. Tel-Aviv, Israel / Tel-Aviv University. Sackler Faculty of Medicine. Tel-Aviv, Israel
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
University of Brescia. Rheumatology and Clinical Immunology. Department of Clinical and Experimental Sciences. Brescia, Italy
University of Milan. Department of Clinical Sciences and Community Health. Milan, Italy / Istituto Auxologico Italiano. Immunorheumatological Research Laboratory. Milan, Italy
University of Utah. Department of Obstetrics and Gynecology. Salt Lake City, UT, United States of America / Intermountain Healthcare. Salt Lake City, UT, United States of America
Weill Cornell Medical College. Hospital For Special Surgery. New York City, NY, United States of America / Kirkland Center for Lupus Research. New York City, NY, United States of America / Lupus and APS Center of Excellence. New York City, NY, United States of America
University of Utah. Department of Obstetrics and Gynecology. Salt Lake City, UT, United States of America
University of Brescia. Rheumatology and Clinical Immunology. Department of Clinical and Experimental Sciences. Brescia, Italy
University of Utah. Department of Obstetrics and Gynecology. Salt Lake City, UT, United States of America / Intermountain Healthcare. Salt Lake City, UT, United States of America
Sheba Medical Center. The Zabludowicz Center for Autoimmune Diseases. Tel-Aviv, Israel / Tel-Aviv University. Sackler Faculty of Medicine. Tel-Aviv, Israel
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
University of Brescia. Rheumatology and Clinical Immunology. Department of Clinical and Experimental Sciences. Brescia, Italy
University of Milan. Department of Clinical Sciences and Community Health. Milan, Italy / Istituto Auxologico Italiano. Immunorheumatological Research Laboratory. Milan, Italy
University of Utah. Department of Obstetrics and Gynecology. Salt Lake City, UT, United States of America / Intermountain Healthcare. Salt Lake City, UT, United States of America
Weill Cornell Medical College. Hospital For Special Surgery. New York City, NY, United States of America / Kirkland Center for Lupus Research. New York City, NY, United States of America / Lupus and APS Center of Excellence. New York City, NY, United States of America
University of Utah. Department of Obstetrics and Gynecology. Salt Lake City, UT, United States of America
University of Brescia. Rheumatology and Clinical Immunology. Department of Clinical and Experimental Sciences. Brescia, Italy
University of Utah. Department of Obstetrics and Gynecology. Salt Lake City, UT, United States of America / Intermountain Healthcare. Salt Lake City, UT, United States of America
Abstract
Pregnancy morbidity is one of the clinical manifestations used for classification criteria of antiphospholipid
syndrome (APS). During the 14th International Congress on Antiphospholipid Antibodies (aPL), a Task Force
with internationally-known experts was created to carry out a critical appraisal of the literature available
regarding the association of aPL with obstetric manifestations present in actual classification criteria (recurrent
early miscarriage, fetal death, preeclampsia and placental insufficiency) and the quality of the evidence that
treatment(s) provide benefit in terms of avoiding recurrent adverse obstetric outcomes. The association of
infertility with aPL and the effectiveness of the treatment of patients with infertility and positive aPL was also
investigated. This report presents current knowledge and limitations of published studies regarding pregnancy
morbidity, infertility and aPL, identifying areas that need better investigative efforts and proposing how critical
flaws could be avoided in future studies, as suggested by participants of the Task Force. Except for fetal death,
there are limitations in the quality of the data supporting the association of aPL with obstetric complications
included in the current APS classification criteria. Recommended treatments for all pregnancy morbidity
associated to APS also lack well-designed studies to confirm its efficacy. APL does not seem to be associated
with infertility and treatment does not improve the outcomes in infertile patients with aPL. In another section
of the Task Force, Dr. Jane Salmon reviewed complement-mediated inflammation in reproductive failure in
APS, considering new therapeutic targets to obstetric APS (Ob APS).
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