Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia
Open accessAbstract
Background Since hypercoagulability might result in recurrent miscarriage, anticoagulant agents could potentially increase the chance of live birth in subsequent pregnancies in women with unexplained recurrent miscarriage, with or without inherited thrombophilia. Objectives To evaluate the efficacy and safety of anticoagulant agents, such as aspirin and heparin, in women with a history of at least two unexplained miscarriages with or without inherited thrombophilia. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 October 2013) and scanned bibliographies of all located articles for any unidentified articles. Selection criteria Randomised and quasi-randomised controlled trials that assessed the effect of anticoagulant treatment on live birth in women with a history of at least two unexplained miscarriages with or without inherited thrombophilia were eligible. Interventions included aspirin, unfractionated heparin (UFH), and low molecular weight heparin (LMWH) for the prevention of miscarriage. One treatment could be compared with another or with no-treatment (or placebo). Data collection and analysis Two review authors (PJ and SK) assessed the studies for inclusion in the review and extracted the data. If necessary they contacted study authors for more information. We double checked the data. Main results Nine studies, including data of 1228 women, were included in the review evaluating the effect of either LMWH (enoxaparin or nadropa…
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A meta-analysis has shown that aspirin and/or LMWH does not increase the live birth rate in women with unexplained recurrent miscarriage and may be associated with adverse effects.
“It should be noted that a meta-analysis has shown that aspirin and/or LMWH does not increase the live birth rate in women with unexplained recurrent miscarriage, may be associated with adverse effects and should therefore not be used.176”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [176]
Meta-analyses of women with recurrent miscarriage combining women with and without thrombophilia have not shown any improvement in reproductive outcomes when using aspirin and/or heparin versus placebo.
“Meta-analyses of women with recurrent miscarriage combining women with and without thrombophilia have not shown any improvement in reproductive outcomes when using aspirin and/or heparin versus placebo.176”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [176]
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References 114 · Cited by 204
- Authors
- de Jong, P. G., Kaandorp, S., Di Nisio, M., Goddijn, M., & Middeldorp, S.
- Affiliations
- Academic Medical Center; Department of Vascular Medicine; Meibergdreef 9 Amsterdam Netherlands 1105 AZ
- Westfriesgasthuis (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2014-07-04
- Volume
- 2014
- Issue
- 7
- Pages
- CD004734-CD004734
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC6769058
- OpenAlex
- W2126945338
- Cited by
- 204
- References
- 114
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 18 · 2023: 15 · 2022: 20 · 2021: 20 · 2020: 15 · 2019: 15 · 2018: 23 · 2017: 18 · 2016: 18 · 2015: 15 · 2014: 2
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- unexplained miscarriage, aspirin, heparin, low molecular weight heparin, enoxaparin, nadroparin, inherited thrombophilia, anticoagulation, live birth, hypercoagulability, pregnancy outcomes, treatment safety, risk of bias, sensitivity analysis, subgroup analysis, follow-up duration
- MeSH terms
- Abortion, Habitual, Anticoagulants, Aspirin, Female, Heparin, Low-Molecular-Weight, Humans, Pregnancy, Pregnancy Complications, Hematologic, Randomized Controlled Trials as Topic, Antiphospholipid Syndrome, Nadroparin, Enoxaparin, Thrombophilia, Live Birth
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