NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.
Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].
Show detailsBibliographic details: Mak A, Cheung MW, Cheak AA, Ho RC. Combination of heparin and aspirin is superior to aspirin alone in enhancing live births in patients with recurrent pregnancy loss and positive anti-phospholipid antibodies: a meta-analysis of randomized controlled trials and meta-regression. Rheumatology 2010; 49(2): 281-288. [PubMed: 19965971]
Abstract
OBJECTIVE: The combination of heparin and aspirin was regarded as the 'standard therapy' for patients with recurrent pregnancy loss (RPL) and positive aPL antibodies to enhance live births, but it largely stems from expert opinion. We performed a meta-analysis of randomized controlled trials (RCTs) to assess whether this combination works better than aspirin alone.
METHODS: RCTs testing the efficacy of a combination of heparin and aspirin vs aspirin alone in patients with RPL and positive aPL antibodies were identified in electronic databases. Random effect meta-analysis was employed to pool relative risks (RRs) (with 95% CI) of live births as the primary outcome. RRs of obstetrical complications and standardized mean difference of birth weight were the secondary outcomes. Mixed-effects meta-regression was performed to identify factors associated with live births.
RESULTS: Data from five trials involving 334 patients were analysed. The overall live birth rates were 74.27 and 55.83% in the combination and aspirin alone groups, respectively. Patients who received heparin and aspirin had significantly higher live birth rate (RR 1.301; 95% CI 1.040, 1.629) than aspirin alone, with the number needed to achieve one live birth being 5.6. No significant differences in pre-eclampsia, preterm labour and birth weight were found between both the groups. Meta-regression using age at randomization, previous history of live births and episodes of miscarriages as covariates failed to predict the RR of live birth.
CONCLUSIONS: The combination of heparin and aspirin is superior to aspirin alone in achieving more live births in patients with positive aPL antibodies and RPL.
- Randomized study of subcutaneous low molecular weight heparin plus aspirin versus intravenous immunoglobulin in the treatment of recurrent fetal loss associated with antiphospholipid antibodies.[Arthritis Rheum. 2003]Randomized study of subcutaneous low molecular weight heparin plus aspirin versus intravenous immunoglobulin in the treatment of recurrent fetal loss associated with antiphospholipid antibodies.Triolo G, Ferrante A, Ciccia F, Accardo-Palumbo A, Perino A, Castelli A, Giarratano A, Licata G. Arthritis Rheum. 2003 Mar; 48(3):728-31.
- Postpartum thrombosis after a successful pregnancy in a recurrent aborter strongly positive for antiphospholipid antibodies.[Acta Obstet Gynecol Scand. 1998]Postpartum thrombosis after a successful pregnancy in a recurrent aborter strongly positive for antiphospholipid antibodies.Katano K, Aoki K, Ogasawara M, Aoyama T, Suzumori K. Acta Obstet Gynecol Scand. 1998 Mar; 77(3):354-6.
- Aspirin plus heparin or aspirin alone in women with recurrent miscarriage.[N Engl J Med. 2010]Aspirin plus heparin or aspirin alone in women with recurrent miscarriage.Kaandorp SP, Goddijn M, van der Post JA, Hutten BA, Verhoeve HR, Hamulyák K, Mol BW, Folkeringa N, Nahuis M, Papatsonis DN, et al. N Engl J Med. 2010 Apr 29; 362(17):1586-96. Epub 2010 Mar 24.
- Review Heparin or aspirin or both in the treatment of recurrent abortions in women with antiphospholipid antibody (syndrome).[Curr Opin Rheumatol. 2011]Review Heparin or aspirin or both in the treatment of recurrent abortions in women with antiphospholipid antibody (syndrome).Hoppe B, Burmester GR, Dörner T. Curr Opin Rheumatol. 2011 May; 23(3):299-304.
- Review The management of pregnant patients with antiphospholipid syndrome.[Lupus. 2004]Review The management of pregnant patients with antiphospholipid syndrome.Cervera R, Balasch J. Lupus. 2004; 13(9):683-7.
- Combination of heparin and aspirin is superior to aspirin alone in enhancing liv...Combination of heparin and aspirin is superior to aspirin alone in enhancing live births in patients with recurrent pregnancy loss and positive anti-phospholipid antibodies: a meta-analysis of randomized controlled trials and meta-regression - Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews
Your browsing activity is empty.
Activity recording is turned off.
See more...