Can People with Antiphospholipid Syndrome (APS) Have Successful Pregnancies?
So, can people with antiphospholipid antibody have successful pregnancies?
The short answer is yes… with a couple of footnotes.
First, it depends a bit on how you were defined as having antiphospholipid antibody.
There are three different blood tests:
- A positive lupus anticoagulant test, a type of clotting test, if present, indicates the highest risk (for losing the baby or having another complication of pregnancy). However, it is easy to get a wrong answer in this test if the doctor or the laboratory are not familiar with it and don’t handle the blood specimen properly.
- A positive test for anticardiolipin antibodies raises concern only if it is very strongly positive. Our own studies suggest that even a strongly positive test, if not accompanied by lupus anticoagulant, may not be as worrisome as we once thought.
- A positive test for antibodies to beta-2-glycoprotein I also has to be strongly positive to be worrisome, and even then, according to our studies, may not suggest high risk.
- The worst scenario is if all three tests are strongly positive.
But don’t despair. These pregnancies are treatable. In our recent study (the largest and most detailed one done to date), pregnancy outcome was about the same as for women with diabetes, kidney disease, or poor socioeconomic conditions. More than 9 of 10 pregnancies survived, and about 8 of 10 pregnancies went to full term. Of course patients were very closely monitored and treated, mostly with a form of injectable heparin (a blood thinner). The common problems were prematurity and high blood pressure (a pregnancy complication seen in many circumstances); the problems occurred most often in patients who also had lupus.
So the answer is yes: women with antiphospholipid antibody have successful pregnancies. You have to be emotionally strong—it will be a very long nine months. And four people—you, your partner, your obstetrician, and your rheumatologist—have to have a good working relationship and understanding of the possibilities, both good and bad. Consult with your physician if you plan on having a pregnancy.