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.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/are-antiphospholipid-antibodies-a-poor-prognostic-factor-for-hellp-syndrome/