PREVALENCE OF LUPUS ANTICOAGULANT AND ANTIPHOSPHOLIPID ANTIBODIES (APLA) IN PREECLAMPTIC PREGNANT WOMEN SEEN AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL (UBTH) BENIN CITY

Abstract

BACKGROUND: Antiphospholipid antibodies (APLA) are heterogeneous group of circulating
antibodies against anionic phospholipids. They have been associated with a number of obstetric
complications however their role in the pathogenesis of preeclampsia has remained an issue of
controversy.
AIMS: The aim of this study is to determine the prevalence of antiphospholipid antibodies in
preeclampsia among women presenting to the University of Benin Teaching Hospital (UBTH)
Benin City.
OBJECTIVES: To determine the frequencies of Lupus anticoagulants and Anticardiolipin
antibodies in preeclampsia; to determine the association between APLA and preeclampsia; to
determine the pregnancy outcome in APLA positive women with preeclampsia and to
determine the relationship between platelet counts and APLA. This is with a view to
recommending screening for APLA to women at risk of preeclampsia.
MATERIALS AND METHODS: This is a cross sectional case control study. Consecutive pregnant
women diagnosed of preeclampsia and age-parity matched normal on-going pregnant women
were recruited as participants for the study. Antiphospholipid antibodies were assayed using
dilute Russel viper’s venom (DRVV) LA kits (LA screen kits and LA confirm kits) and total
anticardiolipin antibody enzyme linked immunosorbent assay (ELISA) based assays.
Haematological parameters were analyzed with haematology automated analyzer MODEL
SYSMEX KN21, Japan.
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RESULTS: A total of 100 women were studied comprising 50 pregnant women with
preeclampsia and age-parity matched 50 normal ongoing pregnant women as control. The
mean ages of the study participants were 31.6 ± 4.7yrs for the preeclamptic women and 30.9 ±
5.4 yrs. Thirty of the preeclamptic women were booked in UBTH while twenty were unbooked.
Eleven of the preeclamptic women had mild preeclampsia while thirty nine had severe
preeclampsia. The prevalence of APLA in preeclampsia was 10% while none (0%) of the
controls was positive. There were no significant differences in the obstetric history, pregnancy
complications, maternal and birth outcomes between APLA positive and APLA negative women
with preeclampsia. However APLA positive preeclamptic women are at increased risk of
abruptio placenta and low birth weight with odd ratios of 5.83 and 1.71 respectively.
CONCLUSION: The prevalence of APLA though increased in women with preeclampsia there is
no association between APLA and preeclampsia in the study participants. Therefore a routine
assay of APLA in women at risk of preeclampsia may not be justified however women with
preeclampsia with other clinical features of antiphospholipid syndrome should be investigated
for APLA.