Antiphospholipid antibodies and fetal loss

To the Editor: Infante-Rivard and colleagues (Oct. lO issue)¹ make an important point that enzyme-linked immunosorbent assays (ELISAs) that can detect low titers of lupus anticoagulant and antiphospholipid antibodies do not distinguish between normal pregnant women and women who have recently had a first miscarriage. However, in stating that “previous investigators have postulated that lupus anticoagulants or anticardiolipin antibodies become risk factors only after a number of fetal losses,” the authors misread earlier data and attempt to answer a question that their study cannot ask. There is consensus that antiphospholipid antibody, used as a marker, is rarely present in normal.