# A study of three-time-point dynamic changes in aPS/PT and standard aPL antibodies and their association with IVF pregnancy outcomes in APS-related recurrent pregnancy loss

## TL;DR

This study tracks antibody levels in APS-related recurrent pregnancy loss patients over time and finds that specific patterns are linked to successful or failed pregnancies.

## Contribution

The study reveals distinct dynamic profiles of aPS/PT antibodies associated with pregnancy outcomes in APS-RPL patients.

## Key findings

- Higher aPS/PT IgM and aCL IgG levels in APS-RPL patients compared to healthy controls.
- Successful pregnancies correlate with reduced aCL IgG, aPS/PT IgM, and aβ2GPI IgM levels post-treatment and during early pregnancy.
- Pregnancy loss is associated with elevated aPS/PT IgM and IgG levels during early pregnancy.

## Abstract

This study aimed to evaluate dynamic anti-phosphatidylserine/prothrombin (aPS/PT) and antiphospholipid (aPL) antibody changes in antiphospholipid syndrome-recurrent pregnancy loss (APS-RPL) patients and their relationship with pregnancy outcomes.

This study included 100 RPL patients with APS features and 30 healthy women who had a normal delivery from 2020 to 2022. First, the differences in aPL and aPS/PT antibody levels between the study group and the control group were compared. Then, a mixed-design repeated measures analysis of variance (RM-ANOVA) was used to assess the time effects, group effects, and their interactions. Pairwise comparisons between time points within each group were performed using one-way repeated measures ANOVA. Finally, antibody levels at each time point were compared between the successful pregnancy group and the pregnancy loss group.

(1) The levels of aPS/PT immunoglobulin M (IgM) and anticardiolipin (aCL) IgG in the study group were significantly higher than those in the control group (P < 0.01). (2) In the successful pregnancy group, both aCL IgG and aPS/PT IgM levels were significantly lower after treatment and during early pregnancy compared to pre-treatment levels, and anti-β2-glycoprotein I (aβ2GPI) IgM was also significantly lower during early pregnancy compared to both pre-treatment and post-treatment levels (P < 0.01). (3) In the pregnancy loss group, aCL IgG was significantly lower after treatment and during early pregnancy compared to pre-treatment levels, but aPS/PT IgM and aPS/PT IgG were significantly elevated during early pregnancy (P < 0.01), showing completely opposite dynamic trends to the successful pregnancy group. (4) Between-group comparisons showed that the pregnancy loss group maintained higher levels of aPS/PT IgM after treatment and during early pregnancy, and aPS/PT IgG levels were also significantly higher during early pregnancy compared to the successful pregnancy group (P < 0.01).

A post-treatment or early-pregnancy decline in aCL IgG, aPS/PT IgM, or aβ2GPI IgM is associated with successful pregnancy in APS-RPL patients, whereas early-pregnancy elevations in aPS/PT IgM and IgG are strongly linked to pregnancy loss. The distinct dynamic profiles of aPS/PT antibodies underscore their relevance to pregnancy outcomes, highlighting the value of longitudinal aPS/PT monitoring for identifying high-risk patients and informing individualized immunologic management.