Occasional antiphospholipid antibody positive patients with recurrent pregnancy loss also merit aspirin therapy: a retrospective cohort-control study.

Abstract

PROBLEM:

It is well known that treatment with aspirin plus heparin is effective for patients with antiphospholipid syndrome (APS) to prevent pregnancy loss. However, it is unclear if occasional antiphospholipid antibodies (aPL) are a risk factor and whether patients with aPL at one time point but not diagnosed as APS should be treated.

METHOD OF STUDY:

We therefore studied whether aspirin alone is effective in patients with occasional aPL who did not meet the criteria for APS. We compared live birth rates between 52 patients with occasional aPL treated with aspirin and 672 unexplained patients with no medication. Patients in both group had a history of two or three pregnancy losses.

RESULTS:

In all, 44 of 52 patients (84.6%) with occasional aPL could experience live birth when treated with aspirin alone. 509 of 672 patients (75.7%) with unexplained pregnancy losses could have babies. When miscarriage cases caused by an abnormal embryonic karyotype were excluded, the success rates were 95.7% (44/46) and 81.2% (509/621), respectively. The live birth rate in patients with occasional aPL treated with aspirin was significantly higher than that in unexplained patients with no medication (P=0.008).

CONCLUSION:

We therefore conclude that aspirin is also useful in patients with occasional aPL but not APS.

• Authors: Mayumi Sugiura-Ogasawara, Yasuhiko Ozaki, Tamao Nakanishi, Takeshi Sato, Nobuhiro Suzumori, Kyoko Kumagai
• Journal: American journal of reproductive immunology (New York, N.Y. : 1989) (Am J Reprod Immunol) Vol. 59 Issue 3 Pg. 235-41 (Mar 2008) ISSN: 1046-7408 [Print] Denmark
• PMID: 18275516 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antibodies, Anticardiolipin
• Antibodies, Antiphospholipid
• Anticoagulants
• Lupus Coagulation Inhibitor
• beta 2-Glycoprotein I
• Aspirin

Topics

• Abortion, Habitual (blood, drug therapy, immunology)
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antibodies, Anticardiolipin (immunology)
• Antibodies, Antiphospholipid (blood, immunology)
• Anticoagulants (therapeutic use)
• Aspirin (therapeutic use)
• Cohort Studies
• Female
• Humans
• Lupus Coagulation Inhibitor
• Pregnancy
• Pregnancy Outcome
• Pregnancy Rate
• Pregnancy, High-Risk (drug effects)
• Retrospective Studies
• Risk Factors
• beta 2-Glycoprotein I (immunology)