ROLE OF ANTIPHOSPHOLIPID ANTIBODIES IN REPEATED MISCARRIAGES

Abstract

Background: Recurrent miscarriage (RM), defined as two or more consecutive pregnancy losses before 20 weeks of gestation, is a significant reproductive health concern with multifactorial etiologies. Antiphospholipid antibodies (APAs) are recognized as one of the leading immunological causes of RM, contributing to placental insufficiency and thrombotic events. In Pakistan, limited data exists on the prevalence and clinical significance of APA among women with RM.

Objective: To determine the prevalence and impact of antiphospholipid antibodies in women with recurrent miscarriages attending a tertiary care hospital in Pakistan.

Methods: A case-control observational study was conducted over six months at the Department of Gynecology and Obstetrics, Liaquat University of Medical and Health Sciences, Jamshoro. Sixty-six women were enrolled through consecutive sampling: 33 cases with ≥2 unexplained miscarriages, and 33 controls with at least one successful full-term birth. Sociodemographic data and obstetric history were recorded. Blood samples were tested for lupus anticoagulant (LAC), anticardiolipin antibodies (aCL IgG and IgM), and anti-β2 glycoprotein I antibodies (IgG and IgM). Antibody positivity was confirmed by repeat testing 12 weeks apart. Data were analyzed using SPSS v21.0, with p-value <0.05 considered significant.

Results: APA positivity was significantly higher among cases than controls (LAC: 33.3% vs. 3.0%; aCL IgG: 30.3% vs. 0%; β2-GPI IgG: 27.3% vs. 3.0%; p < 0.01 for all). APA-positive cases had more miscarriages (mean: 3.1 vs. 2.4) and earlier gestational losses.

Conclusion: Antiphospholipid antibodies are significantly associated with recurrent miscarriage. Early identification and intervention in APA-positive women may improve pregnancy outcomes. Integration of APA screening into clinical protocols is recommended in similar settings.