Activated protein C resistance, but not antiphospholipid antibodies, is associated with recurrent first-trimester spontaneous abortions

* Corresponding author. E-mail: [email protected] Background. The aim of the study was to evaluate the association between the most common laboratory markers of thrombophilias and recurrent first-trimester spontaneous abortions. Materials and methods. During the period from November 2000 to April 2004, a case-control study was carried out at the Department of Obstetrics and Gynecology of Kaunas University of Medicine. Eighty nulliparous women with two or more unexplaned spontaneous abortions ≤13 weeks of gestation and 80 healthy parous women with no history of miscarriages were enrolled into the study. Blood tests for activated protein C resistance (APCR), anticardiolipin antibodies type G (ACLA IgG), anticardiolipin antibodies type A (ACLA IgA) and lupus anticoagulant (LA) were performed in women of both groups. International normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen concentration and platelet count were also analysed in all women. Results. The mean age of patients was 28.1 years in the group of cases and 30.7 years in controls. The mean number of miscarriages was 3.5. APCR was detected in 15% of women with recurrent miscarriage and in 5% of control patients (p < 0.05; OR = 3.4). ACLA IgG were found in 22.5% of cases and in 26.3% of controls (p > 0.05), ACLA IgA in 1.3% and 5% (p > 0.05), respectively. LA was detected in 2.5% women in both groups. APTT was significantly prolonged in women with a positive LA test (p < 0.05). Conclusion. Activated protein C resistance, but not antiphospholipid antibodies, is associated with recurrent first-trimester spontaneous abortions.