ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Maternal and Neonatal Outcomes in Obstetric Antiphospholipid Syndrome: A Retrospective Case-control Study
Provisionally accepted
- 1International Peace Maternity and Child Health Hospital, Shanghai, China
- 2Key Laboratory of Embryo Original Diseases, Shanghai, China
- 3Fudan University Key Laboratory of Medical Molecular Virology, Shanghai, China
- 4Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
- 5Biosafety Level 3 Laboratory of Fudan University, Shanghai, China
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Objective: The combination of low-dose aspirin (LDA) and low-molecular-weight heparin (LMWH) is the standard of care for obstetric antiphospholipid syndrome (OAPS), significantly improving live birth rates. However, whether this regimen fully normalizes the pregnancy course and mitigates risks for both mother and neonate remains unclear. This study aimed to systematically evaluate whether significant maternal and neonatal morbidity persists in OAPS patients despite successful treatment and live birth. Methods: This retrospective cohort study included 256 OAPS patients [166 C-OAPS (the criteria OAPS, patient fulfilled the clinical and the laboratory criteria of Sydney criteria.)], 90 NC-OAPS (non-criteria OAPS, patient fulfilled only the clinical or only the laboratory criteria of Sydney criteria.)] who achieved live birth and 768 matched healthy controls. We compared basic characteristics, laboratory parameters, and perinatal outcomes between the groups. Results: Compared to healthy controls (n=768), treated OAPS patients (n=256) exhibited a persistent hypercoagulable state (elevated D-dimer and FDP, p<0.01) and a higher incidence of anemia (p<0.001). Their neonates had significantly lower birth weight (p=0.006) and elevated risks of neonatal infection (adjusted OR=3.12, p=0.004) and hyperbilirubinemia (adjusted OR=2.06, p=0.024), with the infection risk remaining significant in full-term infants. Subgroup analysis revealed no significant differences in obstetric history, maternal complications, comorbidities, and outcomes between the C-OAPS and NC-OAPS groups. Conclusion: Despite standard treatment, OAPS patients who deliver successfully remain at increased risk for persistent maternal hypercoagulability and adverse neonatal outcomes. These findings underscore the need for a paradigm shift in management—from merely ensuring live birth to safeguarding neonatal health through proactive, multidisciplinary perinatal care.
Keywords: Obstetric Antiphospholipid Syndrome (OAPS), Placental Vasculopathy, Non-CanonicalAntiphospholipid Antibodies, Neonatal Hyperbilirubinemia, Pregnancy-Related Hypercoagulability, Multidisciplinary Perinatal Management
Received: 09 Jul 2025; Accepted: 19 Nov 2025.
Copyright: © 2025 Lin, JIa, Hong, Liang, Dong and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Han Wen Dong, hanwendong@fudan.edmu.cn
Chen Li, lichen_bk@fudan.edu.cn
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