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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (6): 1058-1061. doi: 10.19723/j.issn.1671-167X.2023.06.016

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Correlation of anti-phosphatidylserine/prothrombin antibodies with unexplained recurrent miscarriages

Zhong-qiang YAO,Chang-hong LI,Xin-yi LI,Wei GUO,Jia-yu ZHAI,Rui LIU,Hui WEI,Rong MU*()   

  1. Department of Rheumatology and Immunology, National Key Laboratory for Promoting Female Fertility, Peking University Third Hospital, Beijing 100191, China
  • Received:2023-08-13 Online:2023-12-18 Published:2023-12-11
  • Contact: Rong MU E-mail:murongster@163.com
  • Supported by:
    the Joint Project of the Peking University Third Hospital and the Enterprise(CON20210900013)

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Abstract:

Objective: To investigate whether anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes were correlated with unexplained recurrent miscarriages. Methods: In our a single-center retrospective study, 283 patients with at least one unexplained miscarriage who visited the Third Hospital of Peking University between January 2021 and August 2023, aged between 18-40 years, and tested for anti-phosphatidylserine/prothrombin antibodies IgG or IgM subtypes, were included. The patients with either positive IgG or IgM anti-phosphatidylserine/prothrombin antibody were regarded as positive for anti-phosphatidylserine/prothrombin antibody. SPSS 26.0 software was used for statistical analysis. Chi-square test and Logistic regression analysis were used to study the correlation of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes with unexplained recurrent miscarriages. And the diagnostic sensitivity, specificity, the positive predictive value, the negative predictive value of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes in unexplained miscarriages was calculated with four-fold table. Results: Chi-square analysis showed that anti-phosphatidylserine/prothrombin antibodies and its IgM subtypes were correlated with recurrent miscarriages (both P < 0.05), while the IgG subtype was not correlated with recurrent miscarriages (P>0.05). After adjusting with anticardiolipin antibodies, anti-β2 glycoprotein antibodies, lupus anticoagulants, antinuclear antibodies, and age by Logistic regression analysis, anti-phosphatidylserine/prothrombin antibodies were correlated with unexplained recurrent miscarriages (OR=2.084, 95%CI 1.045-4.155, P < 0.05), and anti-phosphatidylserine/prothrombin antibody IgM subtypes were correlated with unexplained recurrent miscarriages (OR=2.368, 95%CI 1.187-4.722, P < 0.05).The sensitivity of anti-phosphatidylserine/prothrombin antibody in recurrent miscarriage was 65.43%, the specificity was 48.51%, the positive predictive value was 33.76%, and the negative predictive value was 77.78%. In the patients with recurrent miscarriages with negative classical antiphospholipid antibodies, the sensitivity of anti-phosphatidylserine/prothrombin antibody was 59.09%, the specificity was 63.23%, the positive predictive value was 40.63%, and the negative predictive value was 78.40%. The sensitivity of the anti-phosphatidylserine/prothrombin antibody IgM subtype for the diagnosis of recurrent miscarriage was 65.43%, the specificity was 50.99%, the positive predictive value was 34.87%, and the negative predictive value was 78.63%. Conclusion: Anti-phosphatidylserine/prothrombin antibody and IgM subtype antibody are correlated with unexplained recurrent miscarriages in patients with at least one unexplained miscarriage. Whether positive anti-phosphatidylserine/prothrombin antibody or IgM subtype could predict future unexplained recurrent miscarriages warrants a prospective study.

Key words: Anti-phosphatidylserine/prothrombin antibodies, Recurrent miscarriages, Sensitivity, Specificity, Correlation

CLC Number: 

  • R714.21

Table 1

Diagnostic value of PS/PT antibodies in RSA"

Groups RSA(n=81) Non-RSA(n=202) Sum
PS/PT antibody
  Positive 53 104 157
  Negative 28 98 126
PS/PT IgG subtype
  Positive 3 11 14
  Negative 78 191 269
PS/PT IgM subtype
  Positive 53 99 152
  Negative 28 103 131

Table 2

Logistic regression analysis of PS/PT antibody and RSA"

Factors OR 95% CI P value
PS/PT antibodya 1.783 1.045-3.045 < 0.05
PS/PT antibody IgG subtypea 0.618 0.163-2.336 > 0.05
PS/PT antibody IgM subtypea 1.982 1.160-3.385 < 0.05
PS/PT antibodyb 2.084 1.045-4.155 < 0.05
PS/PT antibody IgM subtypeb 2.368 1.187-4.722 < 0.05
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