The role of anti-beta-2 glycoprotein 1 (Anti-β2GP1) testing in antiphospholipid syndrome with pregnancy: A narrative review

Anti-β₂-glycoprotein I antibodies (anti-β₂GPI) are implicated in the antiphospholipid syndrome (APS) pathophysiology. Testing for anti-β₂GPI is of particular importance in pregnant individuals with a high clinical suspicion of APS, who have negative lupus anticoagulant and anticardiolipin antibody results. Despite its diagnostic role, significant challenges remain in risk stratification and laboratory testing procedures, which lead to inconsistencies in clinical research and practice. The present literature review aims to summarize the importance of anti-β₂GPI testing in pregnancy-associated APS, providing a novel perspective by critically evaluating the impact of evolving assay technologies, the implications of the latest international classification criteria, and the ongoing debate surrounding non-criteria antibody isotypes. The literature search was conducted in PubMed, Scopus, and Google Scholar, focusing on original articles published between January 2018 and December 2024. Search terms included: “anti-beta-2 glycoprotein 1,” “anti-β2GP1,” “obstetric antiphospholipid syndrome,” and “pregnancy.” In summary, although anti-β₂GPI antibody testing is indispensable for the APS diagnosis, it is not without challenges, including the lack of international standardization of newer and automated assays.