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Are Antiphospholipid Antibodies a Poor Prognostic Factor for HELLP Syndrome?

M. Pécourt1, C. Yelnik2, L. Ghesquière3, E. Drumez4, E. Cailliau4, E. Hachulla2, V. Debarge3, N. Morel5, V. Le Guern5, C. Garabedian3, N. Costedoat-Chalumeau5, M. Lambert2

1Groupe Hospitalier Paris Saint-Joseph, PARIS, France, 2Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et d’Immunologie clinique, (CeRAINO), (ReCONNECT), U1167 RID-AGE, Lille, France, 3Univ. Lille, CHU Lille, Département de Gynécologie-Obstétrique, Lille, France, 4Univ. Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, Lille, France, 5Université de Paris ; INSERM U1153 ; AP-HP, Service de Médecine Interne, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares, Hôpital Cochin, Paris, France

Abstract Number: OC 33.4

Meeting: ISTH 2021 Congress

Theme: Women Health » Pregnancy and Pregnancy Complications

Background: Characteristics of antiphospholipid syndrome (APS)-associated HELLP syndrome is poorly described, probably due to the low frequency of these two combined conditions.

Aims: This study aimed to compare characteristics and prognosis of HELLP syndrome in patients with and without APS.

Methods: In this multicentric case-control study, adult women diagnosed with HELLP syndrome before 34 gestation weeks, and who were also tested for antiphospholipid antibodies according to international diagnostic recommendations, were included. Cases (“HELLP-APS+”) were defined as patients that fulfilled the international classification criteria for APS syndromeand were retrospectively recruitedby screening the 672 APS patients from our APS database; Controls (“HELLP-APS-”) were defined as patients that did not fulfill APS criteria and were retrospectively recruited from our hospital admission database.

Results: Overall, 71 patients were included (mean age, 30±5 years), 23 patients in HELLP-APS+ group and 48 patients in HELLP-APS- group. The live birth rate was significantly lower for HELLP-APS+ patients compared to HELLP-APS- patients [43.5% versus 89.4%; p<0.001]. The HELLP-APS+ patients gave birth prematurely more often than theHELLP-APS- patients: 24 weeks of gestation (22.0−28.0) versus 30 weeks of gestation (27.0−33.0) (p<0.001). Among HELLP-APS+ patients, 39% required an induced abortion due to HELLP syndrome severity versus 8.5% of HELLP-APS- patients (p=0.006). The intensive care unit admission rate was 61.9% which was significantly higher in HELLP-APS+patients compared to the 27.7% rate of HELLP-APS-patients (p=0.007). No mother died.

Conclusions: Our results suggest that APS is a poor prognostic factor of HELLP syndrome, both for the mother and fetus.

To cite this abstract in AMA style:

Pécourt M, Yelnik C, Ghesquière L, Drumez E, Cailliau E, Hachulla E, Debarge V, Morel N, Le Guern V, Garabedian C, Costedoat-Chalumeau N, Lambert M. Are Antiphospholipid Antibodies a Poor Prognostic Factor for HELLP Syndrome? [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/are-antiphospholipid-antibodies-a-poor-prognostic-factor-for-hellp-syndrome/. Accessed September 21, 2023.

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