Low-molecular-weight heparin versus intravenous immunoglobulin for recurrent abortion associated with antiphospholipid antibody syndrome

Int J Gynaecol Obstet. 2009 Mar;104(3):223-5. doi: 10.1016/j.ijgo.2008.11.010. Epub 2008 Dec 29.

Abstract

Objective: To compare low-molecular-weight (LMW) heparin plus low-dose aspirin with intravenous immunoglobulin (IVIG) in the treatment of antiphospholipid antibody syndrome in women with recurrent spontaneous abortions before 10 weeks of gestation.

Method: This prospective, multicenter trial conducted between 2002 and 2006 included 85 patients aged 18-39 years. The women were allocated randomly to receive LMW heparin plus low-dose aspirin, or IVIG. Data were compared using the t test and Fisher exact test.

Results: The women treated with LMW heparin plus low-dose aspirin had a higher rate of live births than those treated with IVIG (P=0.003). Of those who completed the study, 29/40 (72.5%) and 15/38 (39.5%), respectively, had live births. Intent-to-treat analysis revealed a significant difference between the 2 groups (OR 1.802; 95%CI, 1.14-2.84; P=0.007).

Conclusions: LMW heparin plus low-dose aspirin resulted in a higher live birth rate than IVIG in the treatment of antiphospholipid antibody syndrome in women with recurrent abortion.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Abortion, Habitual / etiology
  • Abortion, Habitual / immunology
  • Abortion, Habitual / prevention & control*
  • Adolescent
  • Adult
  • Anticoagulants / therapeutic use*
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / drug therapy*
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Gestational Age
  • Heparin, Low-Molecular-Weight / administration & dosage
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Factors
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / immunology
  • Pregnancy Outcome
  • Pregnancy, High-Risk
  • Prospective Studies
  • Young Adult

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Aspirin