Table 2.
Baseline patient characteristics associated with APOs in the second and third trimesters
| Total (n = 238) | APOs (n = 34) | No APOs (n = 204) | P-value | |
|---|---|---|---|---|
| Maternal characteristics | ||||
| Age at pregnancy, mean (S.D.) | 31.6 (4.5) | 30.7 (4.8) | 31.7 (4.4) | 0.22 |
| Nulliparity | 88 (37.0) | 11 (32.4) | 77 (37.8) | 0.55 |
| Family geographical origins (n = 235) | ||||
|
166 (70.6) | 21 (61.8) | 145 (72.1) | |
|
29 (12.3) | 7 (20.6) | 22 (11.0) | |
|
17 (7.2) | 2 (5.9) | 15 (7.5) | 0.40 |
|
23 (9.8) | 4 (11.8) | 19 (9.5) | |
| Overweight (BMI ≥ 25 kg/m2) (n = 234) | 71 (30.3) | 14 (41.2) | 57 (28.5) | 0.14 |
| Active smokers (n = 233) | 21 (9.0) | 5 (15.2) | 16 (8.0) | 0.19 |
| Alcohol consumption (n = 226)a | 6 (2.7) | 2 (6.3) | 4 (2.1) | 0.20 |
| Previous IUFD (n = 237) | 16 (6.8) | 5 (14.7) | 11 (5.4) | 0.06 |
| Previous thrombosis | 41 (17.2) | 10 (29.4) | 31 (15.2) | 0.04 |
| Associated APS | 34 (14.3) | 10 (29.4) | 24 (11.8) | 0.01 |
| SLE duration, years, median (IQR) | 7.2 (3.6–12.4) | 10.0 (3.7–15.3) | 7.0 (3.5–11.9) | 0.13 |
| Previous renal involvement | 67 (28.2) | 13 (38.2) | 54 (26.5) | 0.16 |
| Laboratory characteristics | ||||
| Low platelets (<100 × 109/l) | 3 (1.3) | 0 (0.0) | 3 (1.5) | >0.99 |
| 24-h proteinuria >0.5 g/d (or >0.5 g/g) | 9 (3.8) | 3 (8.8) | 6 (2.9) | 0.12 |
| Positive anti-dsDNA (n = 222) | 104 (46.9) | 21 (67.7) | 83 (43.5) | 0.01 |
| Hypocomplementemia (n = 216) | 57 (26.4) | 13 (40.6) | 44 (23.9) | 0.05 |
| At least one positive aPL (n = 232) | 61 (26.3) | 18 (52.9) | 43 (21.7) | <0.001 |
| IgG/IgM aCL (n = 232) | 37 (16.0) | 9 (26.5) | 28 (14.1) | 0.08 |
| IgG/IgM anti-β2GPI (n = 232) | 26 (11.2) | 6 (17.7) | 20 (10.1) | 0.24 |
| LA (n = 232) | 41 (17.7) | 15 (44.1) | 26 (13.1) | <0.001 |
| Triple positive aPL (n = 232) | 17 (7.3) | 5 (14.7) | 12 (6.1) | 0.08 |
| Disease activity and damage | ||||
| PGA, median (IQR) (n = 235) | 0.1 (0–0.2) | 0.1 (0.0–0.4) | 0.1 (0.0–0.2) | 0.06 |
| SLEPDAI, median (IQR) (n = 212) | 2 (0–3) | 2 (2–4) | 2 (0–2) | 0.01 |
| SLICC-Damage Index, median (IQR) (n = 236) | 0 (0–0) | 0 (0–1) | 0 (0–0) | 0.01 |
| Clinical SLEPDAI = 0 | 206 (86.6) | 28 (82.4) | 178 (87.3) | 0.42 |
| Remission (DORIA/Zen definition) | 154 (64.7) | 17 (50.0) | 137 (67.2) | 0.05 |
| Remission (DORIS definition) | 147 (61.8) | 17 (50.0) | 130 (63.7) | 0.13 |
| LLDAS (n = 219) | 157 (71.7) | 19 (57.6) | 138 (74.2) | 0.05 |
| Current treatment | ||||
| Prednisone | 119 (50.0) | 23 (67.7) | 96 (47.1) | 0.03 |
| Prednisone mg/d, median (IQR) (n = 119) | 7 (5–10) | 7.5 (5–10) | 7 (5–10) | 0.13 |
| Immunosuppressive drugsb | 56 (23.5) | 13 (38.2) | 43 (21.1) | 0.03 |
| HCQc | 234 (98.3) | 34 (100.0) | 200 (98.0) | >0.99 |
| Low-dose aspirind | 165 (69.3) | 29 (85.3) | 136 (66.7) | 0.03 |
| Low molecular weight heparin | 61 (25.6) | 15 (44.1) | 46 (22.6) | 0.01 |
| Antihypertensive agents | 5 (2.1) | 2 (5.9) | 3 (1.5) | 0.15 |
S.D.: standard deviation; aCL: anti-cardiolipin; anti-β2GPI: anti-beta2 Glycoprotein I; anti-dsDNA: anti-double stranded DNA; aPL: antiphospholipid; APO: adverse pregnancy outcome; APS: antiphospholipid syndrome; g/d: grams per day; IQR: interquartile range; IUFD: intrauterine foetal death (>10 weeks); LAC: lupus anticoagulant; LLDAS: lupus low disease activity state; PGA: physician global assessment; SLEPDAI: SLE Pregnancy Disease Activity Index.
At least 10 units per week.
Immunosuppressive drugs: Azathioprine (n = 53, 22.3%) and tacrolimus (n = 5, 2.1%); two women received both.
All but four women (98.3%) took HCQ; among those four, intolerance accounted for the lack of HCQ treatment for two, retinopathy for one and non-adherence for the fourth.
Low-dose aspirin was given to 165 women (69.3%). In particular, 52 of 67 patients (71.6%) with previous renal involvement and 56 of 61 patients (91.8%) with at least one positive aPL during pregnancy were treated with low-dose aspirin.
More details on geographical origins are available in Supplementary Table S1, available at Rheumatology online. Bold text highlights significance.