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Background While anti-β2 glycoprotein 1 (anti-β2GP1) antibody positivity is included in the diagnostic criteria for antiphospholipid syndrome (APS), the association between anti-β2GP1 and the obstetrical complications of APS has been inconsistently reported and remains unclear. Objective We completed a case-control study nested within the Canadian Ottawa and Kingston (OaK) Birth Cohort to evaluate the association between anti-β2GP1 antibody positivity and placenta-mediated pregnancy complications. Study Design Five hundred cases were randomly selected among pregnant women who experienced any of the following independently adjudicated placenta-mediated pregnancy complications: preeclampsia, placental abruption, late pregnancy loss (≥ 12 weeks' gestation), and birth of a small-for-gestational age (SGA) infant < 10th percentile. Five hundred pregnant women without any placenta-mediated pregnancy complications were selected as controls. Stored blood samples were analyzed for the presence of anti-β2GP1 antibodies by enzyme-linked immunosorbent assay. Results Anti-β2GP1 immunoglobulin G (IgG) and/or immunoglobulin M (IgM) antibodies in titers ≥ 20 G/M units (> 99th percentile) were present in 24 of 497 (4.8%) of controls and 33 of 503 (6.6%) of cases. There was no significant difference between cases and controls for the composite outcome of any placenta-mediated pregnancy complications (odds ratio, 1.38, 95% confidence interval [CI], 0.8-2.37, p = 0.25). Conclusion Our results call into question the association between anti-β2GP1 antibodies and placenta-mediated pregnancy complications, with further research needed. [ABSTRACT FROM AUTHOR]

Unique considerations are needed when diagnosing and treating venous thromboembolism (VTE) in women who are pregnant or postpartum. What are the risks to the fetus, such as drug exposure or the risk of radiation with diagnostic imaging? How does the physiology of pregnancy affect imaging techniques and anticoagulation management? How should anticoagulation be managed around labor and delivery? These questions highlight some of the important considerations needed when managing a pregnant patient with suspected or confirmed VTE. This review outlines what is known about the epidemiology, pathophysiology, clinical risk factors, diagnosis, and therapeutic management of VTE in pregnancy. We also review our preferred diagnostic and treatment algorithm for a pregnant patient with suspected or confirmed VTE. [ABSTRACT FROM AUTHOR]