Preeclampsia and Fetal Growth Retardation: Is There an Association with Antiphospholipid Antibodies?

Objective: To examine the association between antiphospholipid antibodies and preeclampsia/fetal growth retardation. Methods: In this prospective, observational study, six tests for antiphospholipid antibodies (IgG and IgM anticardiolipin and anticephalin antibody enzyme-linked immunosorbent assays, activated partial thromboplastin time and Russell's viper venom time-based clotting tests) were performed on plasma from 200 unselected women with preeclampsia (145 cases of mild and 55 cases of severe preeclampsia) and 97 normotensive pregnant women of matched gestational age. Main Outcome Measures: Prevalence of antiphospholipid antibodies in preeclamptic women and controls, and the association between these autoantibodies and fetal growth retardation. Results: The IgG anticephalin antibody test and the activated partial thromboplastin time-based test for lupus anticoagulants were both positive in a significantly higher proportion of preeclamptic women (10.5% and 11.5%, respectively) than in controls (3.1% for both tests, P = 0.03 and 0.02, respectively). In the IgG anticardiolipin antibody test, 7.3% of those with severe preeclampsia and 1.0% of the control women were positive (P = 0.04). Five out of six patients with the HELLP syndrome were antiphospholipid antibody positive. No association was found between the presence of antiphospholipid antibodies and fetal growth retardation. Conclusion: The proportion of antiphospholipid antibodies was somewhat higher in preeclamptic than in normotensive pregnant women, but these antibodies were not associated with fetal growth retardation. An association between antiphospholipid antibodies and the HELLP syndrome is suggested.