Aspirin or anticoagulants for the treatment of recurrent pregnancy loss in women without antiphospholipid syndrome

Aspirin or anticoagulants may not be effective for the treatment of recurrent pregnancy loss in women without antiphospholipid syndrome.

A Cochrane review included 9 studies with a total of 1228 subjects. When studies at high risk of bias were excluded, anticoagulants did not have a beneficial effect on live birth, regardless of which anticoagulant was evaluated: Risk ratio (RR) for live birth in women who received aspirin compared to placebo was 0.94, (95% CI 0.80 to 1.11; n = 256), in women who received LMWH compared to aspirin RR 1.08 (95% CI 0.93 to 1.26, n = 239), and in women who received low molecular weight heparin (LMWH) and aspirin compared to no-treatment RR was 1.01 (95% CI 0.87 to 1.16; n = 322). Obstetric complications such as preterm delivery, pre-eclampsia, intrauterine growth restriction and congenital malformations were not significantly affected by any treatment regimen. In included studies, aspirin did not increase the risk of bleeding, but treatment with LWMH and aspirin increased the risk of bleeding significantly in one study.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions), and by imprecise results (few patients).

Ədəbiyyat

1. de Jong PG, Kaandorp S, Di Nisio M, Goddijn M, Middeldorp S. Aspirin or anticoagulants for treating recurrent miscarriage in women without antiphospholipid syndrome. Cochrane Database Syst Rev 2009;(1):CD004734 [Review content assessed as up-to-date: 1 October 2013]. .