Welcome back to my Autoimmune Fertility series. The topic of this blog is anti-phospholipid antibodies and miscarriage. Antiphospholipid antibodies are commonly abbreviated aPL in literature and on lab work. You will see this abbreviation as well as some others explained in this article. Could anti-phospholipid antibodies be affecting your ability to have a healthy pregnancy? Let’s discuss and you can consider for yourself.
Antibody quick review
Here is a quick review about antibodies in general. Antibodies are normal and needed parts of your immune system. They circulate in your blood stream and in body tissues to keep you healthy. Typically, antibodies seek out intruders or foreign substances. These intruders might be bacteria or viruses. In some cases, antibodies can attack your own tissues or in the case of pregnancy: the fetus. This is the nature of autoimmune problems: the body is attacking itself.
Antiphospholipid antibodies and miscarriage
Anti-phospholipid antibodies (aPL) are a specific type of antibody found often in women and men with autoimmune issues, such as Lupus erythematosus. Do keep in mind that persons without obvious disease processes can also have measureable amounts (known as titers in the blood stream) of aPL. Even experts do not know exactly aPL works in your body. However medical research recognizes that the presence of aPL, even in small amounts, is significantly associated with: blood clotting, pregnancy complications and pregnancy loss.1
Treatment success for antiphospholipid antibodies and miscarriage
Treatment enormously improves pregnancy outcomes in women with aPL. Eight research studies reviewed by the 14th International Congress on Antiphospholipid Antibodies found that treatment improved live birth rates by 71-83%.2 My next blog post this week will include most common conventional medicine as well as complimentary medicine treatment approaches. A healthy pregnancy and baby is the key point you. For my part: I strongly advocate testing especially if your history reflects patterns such as those below.3 Additional valuable information is available through local genetic counselors too. These are conversations well worth having with your health care team.
SYMPTOMS ASSOCIATED WITH ANTIPHOSPHOLIPID SYNDROME
(aka Deep Vein Thrombosis or DVT)
|Transitory ischemic attacks (TIA)|
|History of miscarriage||Rashes with lacy or web-like patterns
(aka Livedo reticularis)
|History of stillbirth||Chronic headaches or migraines|
|High blood pressure in pregnancy
|Heart valve diseases|
What tests check for aPL?
Blood testing for aPL’s is available. Currently the 3 most clinically important aPL’s related to reproductive health are:
Lupus anticoagulant (abbreviated as LA)
Anti-cardiolipin antibodies (abbreviated as aCL)
Anti-beta-2-glycoprotein I antibodies (abbreviated as ß1GPI)
It is possible to have only one or two of the above types of aPL in your body or even all three present at the same time. It is recommended to have aPL blood work titers drawn and then redrawn again 12 weeks.4 This is because some brief infections are associated with false-positive results, especially with the aCL test. Please note: there are other types of aCL antibodies beyond those listed above. Tests are available for them as well. However, detailing them goes beyond the scope of this article. If you have further questions, do please leave me a message in the comments section.
This quote is taken from a 2016 extensive review of research in Reproduction journal:
“…there is growing acceptance that LA’s are strongly correlated with disease and that patients who are positive for all three aPL are the most risk of disease (Ruffatti et al. 2011, Galli 2012, Roggenbuck et al. 2012).” 5
Pregnancy problems considered to be related to Anti-phospholipid antibodies (aPL):
- Recurrent spontaneous abortion (miscarriage) before week 10 of pregnancy.
- Development of pre-eclampsia/eclampsia (high blood pressure) before the 34th week of pregnancy.
- Development of placental insufficiency before the 34th week of pregnancy.4
The good news is that both conventional medicine and complimentary medicine treatment drastically improves pregnancy outcomes for women with aPL. Stay tuned for my next blog which addresses both aspects of treatment.
Thank you for reading!
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~Karen Reynolds, RN, MS, LAc
1De Jesus, G. R., Agmon-Levin, N., Andrade, C. A., Andreoli, L., Chighizola, C. B., Porter, T. F., Salmon, J., Silver, R. M., Tincani, A., & Branch, D. W. (2014). 14th International Congres on Antiphospholipid Antibodies Task Force Report on Obstetric Antiphospholipid Syndrome. Autoimmunity Reviews, 13, 795-813. Retrieved from http://dx.doi.org/10.1016/j.autrev.2014.02.0031568-9972/
3 Retrieved from http://www.mayoclinic.org/diseases-conditions/antiphospholipid-syndrome/symptoms-causes/dxc-20307662
4 Pantham, P., Abrahams, V. M., Chamley, L. W. (2106). The role of anti-phospholipid antibodies in autoimmune reproductive failure. Reproduction, 151, R79-R90.
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