Treatment of pregnant women with
antiphospholipid syndrome (APS) should be set apart from that from thrombotic APS patients. Patients with a history of pregnancy morbidity but no vascular
thrombosis are usually treated with a prophylactic dose of
heparin plus low-dose
aspirin; whereas, those with previous vascular
thrombosis alone or associated with previous pregnancy morbidity, are commonly treated with a therapeutic dose of
heparin generally combined with low-dose
aspirin. However, in about 20% of pregnant APS women these regimens fail. In this context, we conducted a case-control study on a large multicentre cohort of conventionally treated pregnancies to verify whether specific laboratory profiles and/or clinical characteristics are predictive of unsuccessful pregnancy outcome during conventional treatments. Multivariate analysis showed that pregnancy failure during conventional
therapies was independently associated with a history of both
thrombosis and pregnancy morbidity, the presence of
systemic lupus erythematosus (SLE) or other systemic
autoimmune diseases and triple
antiphospholipid antibody positivity. With the aim to discover the most effective and safe treatments in high-risk pregnant APS women a large-scale multicentre study focusing on the effect of treatments on pregnancy outcome in women with APS and further risk factors for pregnancy failure has been designed.