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Saturday, September 7, 2013

Trailers (58): Antiphospholipids in stillbirth

Silver, et al. Antiphospholipid antibodies in stillbirth

Why should you read about this topic?

Explaining causes of stillbirth opens the door to effective prevention.

What were the authors trying to do?

Compare the prevalence of antiphospholipid antibodies in deliveries with and without stillbirth

Who participated and in what setting?

Women (stillbirth N=582; live birth N=1547) enrolled at delivery in the Stillbirth Collaborative Research Network between 2006-8

What was the study design?

Multi-center, population-based case-control

What were the main outcome measures?

Maternal serum anticardiolipin antibodies (IgG and IgM) and anti-β2-glycoprotein-I antibodies (IgG and IgM)

What were the results?

Stillbirth was associated with three-fold increased odds of elevated levels of anticardiolipin and anti-β2-glycoprotein-I IgG antibodies

What is the most interesting image in the paper?

Table 3

What were the study strengths and weaknesses?

Strengths: population-based; large number of stillbirths; diverse population; extensive evaluation for causes of stillbirth. Weaknesses: no follow-up antibody testing; no lupus anticoagulant testing

What does the study contribute for your practice?

In cases of unexplained stillbirth, check for maternal antiphospholipid antibodies