First-trimester low-dose prednisolone in refractory antiphospholipid antibody-related pregnancy loss
Abstract
The objective of this study was to assess pregnancy outcome in women with a history of refractory antiphospholipid antibody-associated pregnancy loss(es) who were treated with early low-dose prednisolone in addition to aspirin and heparin. Eighteen women with antiphospholipid antibodies who had refractory pregnancy loss(es) were given prednisolone (10 mg) from the time of their positive pregnancy test to 14 weeks' gestation. Before low-dose prednisolone was given as treatment, 4 (4%) of 97 pregnancies had resulted in live births. Among 23 pregnancies supplemented with prednisolone, 9 women had 14 live births (61%), including 8 uncomplicated pregnancies. The remainder were complicated by preterm delivery, preeclampsia, and/or small-for-gestational-age infants. There were 8 first-trimester miscarriages and 1 ectopic pregnancy. There were no fetal deaths after 10 weeks' gestation and no evidence of maternal morbidity. The addition of first-trimester low-dose prednisolone to conventional treatment is worthy of further assessment in the management of refractory antiphospholipid antibody-related pregnancy loss(es), although complications remain elevated.
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Evidence directly supporting the addition of HCQ or low-dose prednisolone in the first trimester is based on two small observational studies with limited representativeness.
“Evidence directly supporting these treatment options is based on two small observational studies with limited representativeness.56 57”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [57]
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- Authors
- Bramham, K., Thomas, M., Nelson-Piercy, C., Khamashta, M., & Hunt, B. J.
- Affiliations
- King's College London (GB)
- National Health Service (GB)
- Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom;
- Guy's and St Thomas' NHS Foundation Trust (GB)
- Corresponding author
- Bramham, Kate
- Thomas, Mari
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2011-06-23
- Volume
- 117
- Issue
- 25
- Pages
- 6948-6951
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2049326681
- Cited by
- 180
- References
- 27
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 13 · 2023: 7 · 2022: 13 · 2021: 10 · 2020: 17 · 2019: 19 · 2018: 12 · 2017: 13 · 2016: 17 · 2015: 15 · 2014: 15 · 2013: 10 · 2012: 6
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (DRF-2009-02-18)
- British Heart Foundation (FS/10/013/28073)
- 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
- antiphospholipid antibodies, miscarriage, low-dose prednisolone, aspirin, heparin, pregnancy outcomes, ectopic pregnancy, preterm birth, preeclampsia, small for gestational age
- MeSH terms
- Abortion, Spontaneous, Adult, Anti-Inflammatory Agents, Anticoagulants, Aspirin, Female, Heparin, Humans, Prednisolone, Pregnancy, Pregnancy Trimester, First, Antiphospholipid Syndrome, Antibodies, Antiphospholipid
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