Prognostic value of antiphospholipid antibodies in pregnancy outcomes in systemic lupus erythematosus

Zhang, X; Huang, C; Liu, L; Cui, Y; Cai, B; Shi, X; Liu, J; Tian, X; Li, M; Song, Y; Zeng, X; Zhao, J; Chinese Research Committee of Pregnancy and Reproduction in Autoimmune Rheumatic Diseases (CHOPARD)

doi:10.1136/rmdopen-2026-006870

Lupus & antiphospholipid syndrome

Prognostic value of antiphospholipid antibodies in pregnancy outcomes in systemic lupus erythematosus

RMD OpenPublished 30 Jul 2026Cohort study

Main finding · APOsResultOdds ratio 2.56 95% CI 1.38–4.65

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Authors' conclusion

This study demonstrated the adverse effects of aPLs in patients with SLE regarding the pregnancy outcomes, and different aPLs profiles displayed distinct impacts.

Study context

Population: Singleton pregnancies in patients with systemic lupus erythematosus (SLE), single-centre SLE cohort in Chinapregnancies in 410 patients
Participants: 441 pregnancies

Exposure: aPL-positive vs aPL-negative pregnancies in SLE
Outcome: APOs: prefetal death, fetal death, pre-eclampsia or placental insufficiency with severe features before 34 weeks of gestation

Methodological detailssingle-centre

Single-centre

Main finding

APOs

Odds ratio

2.56

95% CI 1.38–4.65

P = 0.002

By group

Positive aPLs29.5%

Negative aPLs13.2%

Positive aPLsvs Negative aPLs

OR 2.56 (95% CI 1.38–4.65); P = 0.002

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	← Lower odds with positive aPLs ←→ Higher odds with positive aPLs →	OR (95% CI)	P value
Fetal deathPositive aPLsvs Negative aPLs	0.050.21520	3.87 (1.17–12.19)	P = 0.021
Failure of live birthPositive aPLsvs Negative aPLs	0.050.21520	2.54 (1.22–5.15)	P = 0.011
	0.050.21520Odds ratio (log scale)

APOs by aPL profile

aCL IgG: OR: 3.02 (95% CI 1.44 to 6.15, p=0.003)
anti-β2GPI IgG: OR: 2.60 (95% CI 1.13 to 5.72, p=0.020)
Lupus anticoagulant (LA): OR: 2.85 (95% CI 1.44 to 5.56, p=0.002)
LA plus IgG aCL and/or anti-β2GPI (highest-risk profile): OR: 3.98 (95% CI 1.66 to 9.35, p=0.002)
Other combinations of aPL positivity: OR: 1.82 (95% CI 0.81 to 3.81, p=0.128)
aCL IgM and anti-β2GPI IgM did not increase APO risk significantly

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Prognostic value of antiphospholipid antibodies in pregnancy outcomes in systemic lupus erythematosus. RMD Open. Published 30 July 2026. doi:10.1136/rmdopen-2026-006870

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