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May 27, 1988

Lupus Anticoagulants and Antibodies to Phospholipids

JAMA. 1988;259(20):2997. doi:10.1001/jama.1988.03720200018017

To the Editor.  —Triplett and associates1 have made important observations about the relationship of lupus anticoagulants, phospholipid antibodies, and clinical disorders.However, they stated that 8% of their patients had a history of spontaneous abortion. Although eight of the 100 patients had a history of recurrent abortions, there were only 50 women in the study. It would be more appropriate to state that eight (16%) of 50 women had a history of recurrent abortion. The 95% confidence intervals for this observation are 7.17% to 29.11%. Recurrent spontaneous abortion, the loss of three or more pregnancies before 20 weeks' gestation, occurs in an estimated 0.4% to 0.8% of women. Spontaneous abortion is clinically recognized in 15% to 20% of pregnancies.2 The association of phospholipid antibodies and recurrent spontaneous abortion should be emphasized. The causative role, if any exists, remains to be elucidated.