Recurrent miscarriage and antiphospholipid antibodies: prognosis of subsequent pregnancy
Open accessAbstract
Background Although women with antiphospholipid antibodies (APLAs) are at increased risk of recurrent miscarriage, the outcome of a subsequent pregnancy is not clearly elucidated.Objectives To assess the pregnancy outcome of a subsequent pregnancy in women with APLAs and compare this outcome with women with unexplained recurrent miscarriage.Methods We performed a cohort study among all women who attended the Miscarriage Clinic at Liverpool Women's Hospital between 1987 and 2006 after being referred due to recurrent miscarriage (≥2 consecutive pregnancy losses). All women underwent a standardized investigation sequence. Women with other reasons for recurrent miscarriage were excluded.Results A total of 693 women fulfilled the selection criteria, of whom 176 (25%) had APLAs. One hundred and twenty-two (69%) women with APLAs had a subsequent live birth compared with 324 (63%) women with unexplained recurrent miscarriage (OR 1.3, 95% CI 0.9-1.9). No differences were found for birth weight, gestational age, and intra-uterine growth restriction. When treatment was analyzed, 53/67 (79%) of women with APLAs who had received aspirin and heparin during their pregnancy had a live birth, compared with 64/104 (62%) of women with APLAs who received aspirin only (adjusted OR 2.7, 95% CI 1.3-5.8). In unexplained recurrent miscarriage, stratification for treatment showed no differences in outcome.Conclusion The prognosis of a subsequent pregnancy in women with APLAs is good. Although this was not a randomized clinical trial, combined treatment of aspirin and heparin seemed associated with a better outcome in women with APLAs, but not in women with unexplained recurrent miscarriage.
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- Authors
- COHN, D. M., GODDIJN, M., MIDDELDORP, S., KOREVAAR, J. C., DAWOOD, F., & FARQUHARSON, R. G.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Liverpool Women's Hospital (GB)
- Corresponding author
- FARQUHARSON, R.G.
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 8
- Issue
- 10
- Pages
- 2208-2213
- ISSN
- 1538-7836 (ISSN-L)
- PMC
- PMC2965809
- OpenAlex
- W2148025649
- Cited by
- 99
- References
- 45
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 7 · 2021: 12 · 2020: 6 · 2019: 12 · 2018: 10 · 2017: 5 · 2016: 2 · 2015: 7 · 2014: 8 · 2013: 6 · 2012: 7
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thrombosis and Haemostasis (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Heart, Lung, and Blood Institute (R01HL065500, R01HL058869)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- recurrent pregnancy loss, antiphospholipid antibodies, subsequent pregnancy outcomes, live birth, aspirin, heparin, unexplained recurrent spontaneous abortion, miscarriage, anticoagulation
- MeSH terms
- Abortion, Habitual, Adult, Anti-Inflammatory Agents, Non-Steroidal, Anticoagulants, Aspirin, Female, Heparin, Humans, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prognosis, Odds Ratio, Antibodies, Antiphospholipid
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