Efficacy of Intravenous Immunoglobulin for Patients with Recurrent Miscarriage: A Meta-Analysis.

IF 1.3 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Iranian Journal of Public Health Pub Date : 2025-06-01 DOI:10.18502/ijph.v54i6.18897

Yan Gao, Limin Peng, Chengkun Yuan, Shanshan Zhang

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引用次数: 0

Abstract

Background: This study aimed to evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) therapy for recurrent miscarriage (RMC) using meta-analysis.

Methods: Literature from Jan 1990 to Feb 2024 was searched in PubMed, etc., using keywords such as "IVIG", "repetitive miscarriage", and "RMC". Two authors independently assessed the literature quality and risk of via Cochrane handbook, and extracted basic information and outcome indicator data. Meta-analysis was performed employing Review Manager 5.3.

Results: Eleven studies were involved, comprising 842 patients, of which 391 received IVIG therapy and 451 received placebo treatment. Relative to placebo group, IVIG group had a notably higher overall live birth rate (OR=2.24, 95% CI=1.68~2.98, Z=5.51, P<0.00001) and a greatly lower miscarriage rate (OR=0.46, 95% CI=0.22~0.95, Z=2.09, P=0.04). Subgroup analysis revealed that both primary and secondary RMC patients in IVIG group had markedly higher live birth rates versus placebo group (OR=2.13, 95% CI=1.18~3.83, Z=2.51, P=0.01; OR=1.50, 95% CI=0.98~2.30, Z=1.96, P=0.04). Nevertheless, the adverse reaction (AR) rate in IVIG group was superior to that in placebo group (OR=4.47, 95% CI=1.01~19.81, Z=1.97, P=0.05).

Conclusion: IVIG can markedly increase the live birth rate, reduce the miscarriage rate, and enhance pregnancy outcomes in patients with RMC. Nevertheless, the rate of ARs with IVIG therapy is relatively high, thus large-scale, multicenter, randomized controlled trials are needed for validation.

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静脉注射免疫球蛋白治疗复发性流产的疗效：一项荟萃分析。

背景：本研究旨在通过荟萃分析评估静脉注射免疫球蛋白（IVIG）治疗复发性流产（RMC）的疗效和安全性。方法：以“IVIG”、“重复性流产”、“RMC”等关键词，在PubMed等网站检索1990年1月~ 2024年2月的文献。两位作者通过Cochrane手册独立评估文献质量和风险，提取基本信息和结局指标数据。采用Review Manager 5.3进行meta分析。结果：共纳入11项研究，842例患者，其中391例接受IVIG治疗，451例接受安慰剂治疗。与安慰剂组相比，IVIG组总活产率显著高于安慰剂组（OR=2.24, 95% CI=1.68~2.98， Z=5.51， PP=0.04）。亚组分析显示，IVIG组原发性和继发性RMC患者的活产率均显著高于安慰剂组(OR=2.13, 95% CI=1.18~3.83， Z=2.51， P=0.01；Or =1.50, 95% ci =0.98~2.30, z =1.96, p =0.04)。但IVIG组不良反应（AR）率明显优于安慰剂组（OR=4.47, 95% CI=1.01~19.81， Z=1.97， P=0.05）。结论：IVIG可显著提高RMC患者的活产率，降低流产率，改善妊娠结局。然而，接受IVIG治疗的ARs发生率相对较高，因此需要大规模、多中心、随机对照试验来验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Iranian Journal of Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

2.20

自引率

7.10%

发文量

300

审稿时长

3-8 weeks

期刊介绍： Iranian Journal of Public Health has been continuously published since 1971, as the only Journal in all health domains, with wide distribution (including WHO in Geneva and Cairo) in two languages (English and Persian). From 2001 issue, the Journal is published only in English language. During the last 41 years more than 2000 scientific research papers, results of health activities, surveys and services, have been published in this Journal. To meet the increasing demand of respected researchers, as of January 2012, the Journal is published monthly. I wish this will assist to promote the level of global knowledge. The main topics that the Journal would welcome are: Bioethics, Disaster and Health, Entomology, Epidemiology, Health and Environment, Health Economics, Health Services, Immunology, Medical Genetics, Mental Health, Microbiology, Nutrition and Food Safety, Occupational Health, Oral Health. We would be very delighted to receive your Original papers, Review Articles, Short communications, Case reports and Scientific Letters to the Editor on the above mentioned research areas.