I read with great interest the article by Silver et al regarding antiphospholipid antibody testing in stillbirth. Extensive evaluations were performed in an attempt to assign a cause for the fetal death, and antiphospholipid testing was performed routinely. The findings included the presence of one or more antiphospholipid antibodies in almost 10% of patients with stillbirth, but also in 6% of control patients with live births. The adjusted odds ratio for both immunoglobulin (Ig)G anticardiolipin and anti-beta2-glycoprotein-l antibodies was approximately 3. Abnormal antiphospholipid antibody test results were present in a similar proportion of patients with stillbirths with and without complications. The authors conclude that testing for antiphospholipid antibodies in patients with unexplained stillbirth is reasonable, and that testing for all four antibodies is warranted.
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