***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the prevalence in normal pregnancies of anti-32 glycoprotein I ( anti-beta2GPI ) antibodies , and their association with obstetrical complications . STUDY DESIGN Prospect i ve study of anti-beta2GPI and anticardiolipin ( CL ) antibodies in 510 healthy pregnant women at 15 - 18 weeks . According to the results , women were categorized into three groups : group I , negative for both antibodies ; group II , positive for anti-beta2GPI antibodies ; group III , positive for aCL only . The rates of fetal loss , abruptio placentae , preeclampsia-eclampsia , and fetal growth retardation were compared in the three groups . RESULTS  Anti-beta2GPI antibodies  were found in 20 women ( 3.9 % ) and aCL in 8 patients ( 1.6 % ) . Obstetrical complications were more frequent , even if not significantly different , in group II , 15 % , than in group I , 4.1 % ( difference 10.9 % ; 95 % confidence interval ( CI ) : 1.6 - 20.2 % ; p=0.0575 ) , while no complications were seen in group III . Preeclampsia-eclampsia were significantly more frequent in group II ( 10 % ) than in group I ( 0.8 % ; difference 9.2 % ; 95 % CI : 4.4 - 14 % ; p=0.021 ) . The prevalence of fetal growth retardation was not significantly different in the two groups ( 5 % vs. 2 % , respectively ) . COMMENT Our findings indicate that anti-beta2GPI antibodies are associated with some obstetrical complications , mainly preeclampsia-eclampsia , even if more conventional antiphospholipid antibodies are not present . This observation suggests that these antibodies should be investigated in such cases , in order to improve the outcome of subsequent pregnancies , as well as in women with a history of early and /or recurrent severe preeclampsia in order to start a prophylactic treatment ( i.e. low-dose aspirin or heparin ) Objective To investigate the association of anticardiolipin antibody with the genesis of spontaneous abortion , fetal growth restriction ( FGR ) , and preeclampsia . Methods Eight hundred sixty pregnant women constituted the study population .  Anticardiolipin antibody was screened by enzyme-linked immunosorbent assay during the first trimester of pregnancy . The outcome of pregnancy in these women was analyzed prospect ively , and the rate of occurrence of spontaneous abortion , preeclampsia , and FGR was compared in the anticardiolipin antibody-positive and -negative groups . Results  Anticardiolipin antibody  was positive in 60 of the 860 women ( 7.0 % ) and negative in 800 ( 93.0 % ) . The rate of spontaneous abortions in the anticardiolipin antibody-positive group , 25.0 % , was significantly higher than that in the anticardiolipin antibody-negative group , at 9.8 % ( P < .001 ; relative risk [ RR ] 2.56 , 95 % confidence interval ( CI ) 1.37–4.81 ) . The rates of preeclampsia ( 11.7 % ) and FGR ( 11.7 % ) in the anticardiolipin antibody-positive group were also significantly higher than those in the -negative group ( 1.9 and 1.9 % , respectively ; for preeclampsia , P < .001 ; RR 6.22 , 95 % CI 2.43–16.0 and for FGR , P < .001 ; RR 6.22 , 95 % CI 2.43–16.0 ) . Conclusion Anticardiolipin antibody is associated with adverse outcomes of pregnancy such as spontaneous abortion , preeclampsia , and FGR OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity OBJECTIVE To estimate whether antiphospholipid antibodies , specifically anticardiolipin and anti – β2-glycoprotein-Iantibodies , are associated with preeclampsia . METHODS Plasma was prospect ively obtained from four groups of pregnant women : those with 1 ) mild preeclampsia ( n = 109 ) ; 2 ) severe preeclampsia ( n = 134 ) ; 3 ) hemolysis , elevated liver enzymes , low platelets ( HELLP ) syndrome ( n = 57 ) ; and 4 ) normotensive controls ( n = 100 ) .  Anticardiolipin and anti – β2-glycoprotein-I levels  were determined by enzyme-linked immunoassay . RESULTS Subjects with mild preeclampsia , severe preeclampsia , and HELLP syndrome did not have significantly elevated levels of immunoglobulin G ( IgG ) and IgM anticardiolipin and anti – β2-glycoprotein-I antibodies compared with normotensive controls ( P > .05 , Kruskal – Wallis ) . Similarly , subjects with mild preeclampsia , severe preeclampsia , and HELLP syndrome did not have a significantly higher proportion of women testing positive for each autoantibody compared with normotensive controls ( χ2 ) . The proportion of patients testing positive for anticardiolipin and anti – β2-glycoprotein-I antibodies were similar in patients with preeclampsia developing before and after 34 weeks ' gestation ( χ2 ) . CONCLUSION Circulating levels of both anticardiolipin and anti – β2-glycoprotein-I antibodies were not increased in patients with mild preeclampsia , severe preeclampsia , or HELLP syndrome compared with normotensive controls . Our data do not support routine testing for anticardiolipin and anti – β2-glycoprotein-I antibodies in women with preeclampsia Objective : To determine whether specific subtypes of early-onset hypertensive disorders of pregnancy ( haemolysis , elevated liver enzymes , low platelets [ HELLP ] syndrome ; severe preeclampsia ; eclampsia ; and fetal growth restriction ) differ in increased prevalences of thrombophilic disorders . Design : Cohort study . Setting : Two university hospitals in Amsterdam , the Netherl and s. Population : 216 patients participating in a r and omized clinical trial with severe and early-onset hypertensive disorders of pregnancy . Methods : More than 3 months after delivery , all patients were invited for a thrombophilia screening protocol , including hereditary thrombophilic disorders ( Factor II or V-Leiden mutation , APC-resistance , protein S deficiency ) , antiphospholipid antibodies ( anticardiolipin antibodies and lupus anticoagulant activity ) , and hyperhomocysteinemia ( before and after methionin challenge ) . Disease expression was classified by HELLP syndrome , severe preeclampsia , or neonatal birth weight ratio below the median ( 0.65 ) . Univariate and multinomial regression analyses examined the association of disease expression with thrombophilic disorders , and other associated factors ( chronic hypertension , smoking , body mass index , positive family history of cardiovascular morbidity , and demographic parameters ) . Main outcome measures : incidence of thrombophilic disorders in different subtypes of disease . Results : Overall prevalence of thrombophilic disorders in 206 ( 95 % ) screened women was 36 % . Chronic hypertension was present in 32 % , and 34 % had a positive family history of cardiovascular morbidity . Multinomial regression analysis showed that hereditary thrombophilia was more frequent among women with infants with a birth weight ratio < 0.65 than in women with HELLP syndrome or severe preeclampsia ( p = 0.01 , OR 5.1 ( 1.5 to 7.3 ) and OR 3.4 ( 1.1 to 10.6 ) , respectively ) . High body mass index was less frequent in women with HELLP syndrome than in those with severe preeclampsia or fetal growth restriction ( p = 0.06 , OR 0.5 ( 0.3 to 0.9 ) and OR 0.4 ( 0.2 to 1.0 ) , respectively ) . Conclusion : In this population , the high prevalence of thrombophilic factors and chronic hypertension was confirmed . There were small differences between groups . Hereditary thrombophilic disorders were associated with fetal growth restriction but not with type of maternal disease , suggesting an effect on placental function . Maternal body mass index was lower in women with HELLP syndrome OBJECTIVE The aim of this prospect i ve study was to determine the impact of thrombophilia on the recurrence of preeclampsia . STUDY DESIGN In a multicenter , observational , cohort design , 172 white patients with a previous pregnancy complicated by preeclampsia were observed in the next pregnancy . They were evaluated for heritable thrombophilia ( factor V Leiden and factor II G20210A mutations , protein S , protein C , and antithrombin deficiency ) , hyperhomocystinemia , lupus anticoagulant , and anticardiolipin antibodies . Development of preeclampsia and maternal complications and both gestational age at delivery and birthweight were recorded . RESULTS Sixty women ( 34.9 % ) showed the presence of a thrombophilic defect . They had a higher risk for the recurrence of preeclampsia ( odds ratio [ OR ] , 2.5 ; 95 % confidence interval [ CI ] , 1.2 - 5.1 ) , compared to patients without thrombophilia . Similar findings were observed considering only heritable thrombophilia . Thrombophilic patients were at increased risk for the occurrence of very early preterm delivery ( < 32 weeks ; OR , 11.6 ; 95 % CI , 3.4 - 43.2 ) . CONCLUSION When counseling white women with a history of preeclampsia , screening for thrombophilia can be useful for preconceptional counseling and pregnancy management Antiphospholipid antibody ( aPL ) is associated with thromboembolism . There is scant evidence of a relationship between the aPL profile and serious adverse pregnancy outcome . The aim of this study was to assess whether aPL measurements during early pregnancy were useful in predicting a serious adverse pregnancy outcome . In this prospect i ve study , we measured aPLs , including lupus anticoagulant ( LA ) , IgG , IgM , IgA anticardiolipin antibody ( aCL ) , IgG , IgM phosphatidylserine-dependent antiprothrombin antibody , and IgG kininogen-dependent antiphosphatidylethanolamine antibody ( aPE ) during the first trimester in a consecutive series of 1155 women . The 99 th percentile cut-off values in each aPL were determined using sample s from 105 women who did not exhibit any pregnancy morbidity . We assessed the predictive risk of a serious adverse pregnancy outcome adjusted for confounding factors . We found that IgG aCL was associated with developing pregnancy-induced hypertension ( PIH ) ( odds ratio 11.4 , 95 % CI 2.7 - 48 ) ; IgG aPE with PIH ( 8.3 , 2.4 - 29 ) , severe PI 
    Output:
    
: Moderate-to-high levels of anticardiolipin antibodies are associated with preeclampsia , but there is insufficient evidence to use anticardiolipin antibodies as predictors of preeclampsia in clinical practice