A review of the impact of isolated antiphospholipid antibody positivity on pregnancy outcomes and clinical management strategies

Objective This review summarizes the current evidence on the impact of isolated antiphospholipid antibody positivity (IAAP) on pregnancy outcomes. It analyzes risk differentials across antibody subtypes, synthesizes the underlying pathophysiological mechanisms, and reviews existing treatment strategies to inform clinical practice. Methods A comprehensive review was conducted. Data were retrieved and analyzed from relevant observational, cohort, and randomized controlled trials, both domestically and internationally, focusing on clinical outcomes, risk stratification, pathogenic mechanisms, and the management of IAAP. Results Positive antiphospholipid antibodies alone constitute a risk factor for adverse pregnancy outcomes. The pathological mechanisms linking IAAP to adverse outcomes involve multiple processes, including thrombosis, trophoblast dysfunction, and complement activation. Clinical management should involve risk stratification based on antibody profiles. For high-risk patients, a combination therapy of low-molecular-weight heparin and aspirin is recommended, with hydroxychloroquine as a potential adjuvant. Standardization of antibody testing and optimal timing for dynamic monitoring remain areas needing improvement. Conclusion and future perspectives IAAP is associated with an increased risk of adverse pregnancy outcomes. Further research is needed to determine whether the presence of these antibodies may contribute to the development of autoimmune disease. Future research should focus on developing precise risk-stratification models that integrate antibody type, titer, and clinical features. Prospective studies are warranted to establish individualized monitoring and intervention protocols, ultimately contributing to an evidence-based clinical consensus.