Pregnancy outcome in women with antiphospholipid syndrome on low-dose aspirin and heparin: a retrospective study
Open accessAbstract
This retrospective review of hospital records analysed pregnancy outcome with 2 different treatments for women with recurrent miscarriage diagnosed with antiphospholipid syndrome in the index pregnancy. Of 64 women, 29 had received aspirin and 35 aspirin plus heparin. Pregnancy-induced hypertension, prematurity, intrauterine growth restriction and neonatal death were considered as maternal and fetal complications. There were no significant differences in antenatal and maternal complications between the groups. HOwever, there were significant differences in mean anticardiolipin IgG antibody levels. Aspirin alone or in combination with parin was equally efficacious in women with antiphospholipid syndrome and recurrent miscarriage.
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Pooled data from one RCT in women with first-trimester losses and eight observational studies not exclusively early losses indicated higher likelihood of live births with LDA plus prophylactic heparin versus LDA alone.
“Pooled data from one RCT including only patients with a history of first trimester losses46 and eight supporting observational studies47–54 that did not exclusively study women with early pregnancy losses indicated a higher likelihood of live births with combination treatment with LDA and heparin at prophylactic dosage versus LDA alone.”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [49]
This paper is a retrospective observational study, but its Abstract concludes that aspirin alone and aspirin plus heparin were equally efficacious in women with antiphospholipid syndrome and recurrent miscarriage. Its Introduction reports that other randomized trials favored combination treatment; it does not present its own study as supporting a higher likelihood of live birth with heparin. (LLM, conf=0.84)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredIn women with a history of fetal loss, LDA plus heparin was associated with higher likelihood of live birth than LDA alone.
“For women with a history of fetal loss, combination treatment with LDA and heparin was associated with a higher likelihood of live birth compared with treatment with LDA alone.”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [49]
The Introduction and Discussion (pages unavailable in our copy) report two trials in aPL-positive women with recurrent miscarriage that found higher live-birth rates with aspirin plus heparin than with aspirin alone. But the cited paper’s own retrospective study concludes that the treatments were equally efficacious. The claim also omits the APS/aPL and recurrent-loss qualifications on the women studied. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe studies on fetal loss included women with histories of both early and mid-pregnancy losses.
“However, these studies included women with histories of both early and mid-pregnancy losses.48–52”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [49]
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- Authors
- Naru, T., Khan, R. S., & Ali, R.
- Affiliations
- Aga Khan University (PK)
- ORCID
- Khan, R.S.
- Venue
- Eastern Mediterranean Health Journal
- Published
- 2010-03-01
- Volume
- 16
- Issue
- 03
- Pages
- 308-312
- ISSN
- 1020-3397 (ISSN-L)
- 1687-1634
- OpenAlex
- W115642794
- Cited by
- 15
- References
- 18
- Citations by year
- 2025: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 5 · 2012: 2
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Eastern Mediterranean Health Journal (publishedVersion)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- antiphospholipid syndrome, recurrent pregnancy loss, low-dose aspirin, heparin, pregnancy outcomes, gestational hypertension, preterm birth, fetal growth restriction, neonatal death, anticardiolipin antibodies, maternal complications, fetal complications
- MeSH terms
- Adult, Aspirin, Drug Therapy, Combination, Female, Fibrinolytic Agents, Heparin, Humans, Immunoglobulin G, Immunoglobulin M, Pakistan, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Retrospective Studies, Chi-Square Distribution, Antiphospholipid Syndrome, Treatment Outcome, Antibodies, Anticardiolipin
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