Impact of heparin-aspirin therapy in patients with recurrent pregnancy loss characterized by thrombophilia resistant to low-dose aspirin therapy: A retrospective study.

IF 2.7 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Reproductive Medicine and Biology Pub Date : 2025-03-26 eCollection Date: 2025-01-01 DOI:10.1002/rmb2.12643
Tomoko Ichikawa, Takami Watanabe, Yumene Kubota, Shigeru Matsuda, Daisuke Shigemi, Sayuri Kasano, Ryoko Yokote, Mirei Yonezawa, Nozomi Ouchi, Yasuyuki Negishi, Yoshimitsu Kuwabara, Toshiyuki Takeshita, Shunji Suzuki
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引用次数: 0

Abstract

Purpose: Heparin and aspirin (HA) therapy is used for antiphospholipid syndrome (APS)-associated recurrent pregnancy loss (RPL). Low-dose aspirin (LDA) is recommended for thrombophilic predispositions, such as antiphospholipid antibodies that do not completely meet the Sydney classification criteria for APS, protein S deficiency, factor XII deficiency and increased platelet aggregation. However, no established strategy exists for cases where LDA is ineffective. Therefore, this study aimed to identify the characteristics of RPL cases unresponsive to LDA and to determine whether HA is more effective than LDA in such cases.

Methods: A total of 913 LDA-treated pregnancies were categorized into live births and miscarriages, and their characteristics were retrospectively analyzed.

Results: The live birth rates following one, two, or three or more LDA therapies were 78.5%, 61.5% and 16.7%, respectively. Live birth rates were significantly lower when lupus anticoagulant (LAC) aPTT was positive but did not qualify as obstetric APS following LDA therapy (birth rates: 33.3%, p = 0.048). Three or more LDA therapies decreased the live birth rate, whereas HA therapy significantly increased the live birth rate (p = 0.0019).

Conclusions: HA therapy is recommended over repeated LDA treatment, particularly when LAC aPTT is positive but does not qualify as obstetric APS.

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来源期刊
CiteScore
5.70
自引率
5.90%
发文量
53
审稿时长
20 weeks
期刊介绍: Reproductive Medicine and Biology (RMB) is the official English journal of the Japan Society for Reproductive Medicine, the Japan Society of Fertilization and Implantation, the Japan Society of Andrology, and publishes original research articles that report new findings or concepts in all aspects of reproductive phenomena in all kinds of mammals. Papers in any of the following fields will be considered: andrology, endocrinology, oncology, immunology, genetics, function of gonads and genital tracts, erectile dysfunction, gametogenesis, function of accessory sex organs, fertilization, embryogenesis, embryo manipulation, pregnancy, implantation, ontogenesis, infectious disease, contraception, etc.
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