The association of antiphospholipid syndrome under medical treatment with adverse pregnancy outcomes

Objectives We aim to clarify the association and strength of association between antiphospholipid syndrome (APS) and adverse pregnancy outcomes. Methods Our study included an analysis of 191 hospitalized singleton pregnant women with APS and 984 healthy singleton pregnant women at Obstetrics and Gynecology Hospital Affiliated to Fudan University from July 2017 to September 2023. The exposure factor was diagnosed as antiphospholipid syndrome, and the main outcomes were adverse pregnancy outcomes, including miscarriage, preterm birth, low birth weight, gestational hypertension, and eclampsia. Results Our analysis indicated that the odds ratio (OR) for miscarriage in APS patients was 2.50 (95 % CI, 1.025 ± 15.794; p=0.046), for preterm birth was 2.8 (95 % CI, 1.025 ± 15.794; p=0.046), for low birth weight was 2.28 (95 % CI, 1.025 ± 15.794; p=0.046), and for fetal growth restriction was OR=2.48 (1.45, 4.23) p<0.05. The OR for preeclampsia was 1.00, and for gestational hypertension was 0.96, p>0.05. After adjustment for confounders of age and BMI confounders, the odds ratio (OR) for miscarriage was 2.50 (95 % CI: 1.52–4.11) p<0.05. Preterm birth was 2.89 (95 % CI: 1.79–4.65) p<0.05, low birth weight was 2.28 (95 % CI: 1.52–3.55) p<0.05, intrauterine growth restriction was 2.48 (95 % CI: 1.45–4.23) p<0.05. The OR of preeclampsia was 1.00 (95 % CI: 0.59–1.71) p>0.05, and that of pregnancy-induced hypertension was 0.96 (95 % CI: 0.53–1.75) p>0.05. After adjustment for confounders of age, BMI, eclampsia and diabetes, the OR for preterm infants were 3.06 (95 % CI: 1.87–5.00) p<0.05, and those of low birth weight infants were 2.55 (95 % CI: 1.49–4.37) p<0.05. After adjustment for confounders of age, BMI, diabetes, eclampsia, and gestational week, the OR for low birth weight infants was 2.02 (95 % CI: 1.26–3.26) p<0.05. Conclusions Antiphospholipid syndrome was significantly associated with the risk of miscarriage, preterm birth, low birth weight, and intrauterine growth restriction as adverse pregnancy outcomes.