Antiphospholipid antibodies and recurrent pregnancy loss among women seen at Mulago hospital: A matched case control study

Abstract

Introduction: Recurrent pregnancy loss (RPL) is spontaneous loss of three or more consecutive pregnancies. One of the important causes of RPL is Antiphospholipid antibodies (APA). Recurrent abortions constituted 28.6% of patients seen with abortions at Mulago Hospital in the period November to December 2013. It is not known how much of the recurrent abortions are due to APA. The aim of this study was to establish the frequency of APA among women with RPL so as to guide on protocols for management/investigation of these patients. Objective: To determine whether women with RPL have higher frequency of positive APA levels compared to women who have normal pregnancies at Mulago Hospital. Methods: We conducted a matched case control study at Mulago Hospital. A total of 82 participants were enrolled. Cases (n= 41) were women with recurrent pregnancy loss while controls (n=41) were pregnant women with no history of pregnancy loss in the ratio of 1:1. Assays for the presence of Antiphospholipid antibodies were done using quantitative ELISA method on serum that was extracted from the collected blood samples. Antibody levels were measured for women who tested positive for Antiphospholipid antibodies. Frequencies and percentages were used to show proportion of women with positive APA among cases and controls. Categorical data was summarized using percentages while continuous data was summarized using means. Odds ratios were used to analyse the strength of the association between APA and RPL. Pearson Chi-square tests were used for categorical variables while Wilcoxon and Fishers exact tests were used for continuous variables that had outcomes measuring < 5 at bivariate analysis. P-values of < 0.05 were considered statistically significant, with the confidence interval set at 95%. Results: In this study, 9.8 % (4/41) of the cases and 2.4 % (1/41) of the controls were positive for APA. However, this difference was not statistically significant (p-value of 0.375). Positive APA levels were moderate to high titers in the RPL group while in the control group they were low. Conclusion: There was no significant difference in the frequency of APA between cases and controls. However, positive APA levels were seen to be higher among cases than controls.