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However, the clinical relevance of low aCL levels (&lt;40\u2009MPL\/GPL units) is still a matter of debate. The aim of the study was to evaluate obstetric outcomes in pregnancies with low immunoglobulin M (IgM) and\/or immunoglobulin G (IgG) aCL positivity. The association between low aCL positivity and maternal baseline characteristics was also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>The retrospective monocentric cohort study of prospectively collected data involved a total 3047 singleton pregnancies that underwent the first\u2010trimester screening involving an aCL test and delivered on site. Obstetric outcomes were compared between the low\u2010titer aCL group (IgM \u22657\u2009MPL units and &lt;40\u2009MPL units and\/or IgG \u226510\u2009GPL units and &lt;40\u2009GPL units) and the aCL negative group (IgM &lt;7\u2009MPL units and IgG &lt;10\u2009GPL units, reference group). In addition, obstetric outcomes were evaluated with regard to the antibody isotype: IgM\u2010positive group (IgM &lt;40\u2009MPL units, IgG negative) and IgG\u2010positive group (IgG &lt;40\u2009GPL units, IgM negative or &lt;40\u2009MPL units).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, the occurrence of pregnancy\u2010related complications was significantly higher (27.91% vs. 19.32%, <jats:italic>p<\/jats:italic>\u2009=\u20090.034) in the low\u2010titer aCL group. Concerning the antibody isotype, a higher rate of pregnancy\u2010related complications was observed in the IgG\u2010positive group (54.55% vs. 19.32%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), but not in the IgM\u2010positive group (22.43% vs. 19.32%, <jats:italic>p<\/jats:italic>\u2009=\u20090.454). The stillbirth rate did not reach statistical significance. Low\u2010titer aCL pregnancies were more frequently of advanced maternal age (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), suffered from autoimmune diseases (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), chronic hypertension (<jats:italic>p<\/jats:italic>\u2009=\u20090.040), and hereditary thrombophilia (<jats:italic>p<\/jats:italic>\u2009=\u20090.040). In addition, they had more often a positive history of stillbirth (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), underwent conception via assisted reproductive technologies (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), were administered low\u2010dose aspirin (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), low\u2010molecular\u2010weight heparin (<jats:italic>p<\/jats:italic>\u2009=\u20090.018) and immunomodulatory drugs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and delivered earlier (<jats:italic>p<\/jats:italic>\u2009=\u20090.018).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Even low aCL levels are associated with a higher incidence of pregnancy\u2010related complications, but only in the case of IgG antibody isotype presence. Screening for aCL in the first trimester has some prognostic value, but further studies are needed to determine whether its potential implementation into routine clinical practice would improve antenatal care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15096","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:45:01Z","timestamp":1742197501000},"page":"897-905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Even low levels of anticardiolipin antibodies are associated with pregnancy\u2010related complications: A monocentric cohort study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9897-4259","authenticated-orcid":false,"given":"Veronika Viktoria","family":"Matraszek","sequence":"first","affiliation":[{"name":"Department of Molecular Biology and Cell Pathology, Third Faculty of Medicine Charles University  Prague Czech 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