PMID- 31872490
OWN - NLM
STAT- MEDLINE
DCOM- 20210114
LR  - 20210114
IS  - 1600-0897 (Electronic)
IS  - 1046-7408 (Linking)
VI  - 83
IP  - 4
DP  - 2020 Apr
TI  - Comparison of therapeutic interventions for recurrent pregnancy loss in 
      association with antiphospholipid syndrome: A systematic review and network 
      meta-analysis.
PG  - e13219
LID - 10.1111/aji.13219 [doi]
AB  - Antiphospholipid syndrome (APS) is one of the treatable causes for pregnant women 
      with recurrent pregnancy loss (RPL). This review compares the efficacy of a few 
      treatment interventions (low-dose aspirin (LDA), aspirin plus low molecular 
      weight heparin (LMWH), or unfractionated heparin (UFH)) in preventing 
      complications during pregnancy and miscarriages for women with RPL and APS, and 
      the potential differences in therapeutic effects of UFH and LMWH when combined 
      with aspirin. We searched randomized controlled trials (RCTs) in MEDLINE, EMBASE, 
      and the Cochrane Central Register of Controlled Trials and performed a systematic 
      review and a Bayesian network meta-analysis (NMA). Finally, we found aspirin 
      alone had a lower live birth rate compared to LMWH plus aspirin (OR = 0.37; 95% 
      CrI, 0.17, 0.71), and UFH plus aspirin showed a higher live birth rate than 
      aspirin alone (OR = 2.63; 95% CrI, 1.04, 5.39) in NMA, treating with UFH plus 
      aspirin or LMWH plus aspirin did not have difference on live birth. Furthermore, 
      LDA alone resulted in a lower birthweight compared to heparin plus aspirin, while 
      higher birthweight was found when compared UFH plus aspirin to LMWH plus aspirin 
      (MD = 895.40; 95% CrI, 817.40, 988.57) in NMA. Additionally, in women with RPL 
      and APS and without a prior thrombosis, heparin plus aspirin improved birthweight 
      but could not promote live birth rate compared to aspirin alone. In conclusion, 
      heparin plus aspirin is recommended for women with RPL and APS. Notably UFH plus 
      aspirin demonstrates the most significant therapeutic efficacy among these 
      interventions in improving birthweight.
CI  - (c) 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Liu, Xiang
AU  - Liu X
AD  - Department of Gynecology and Obstetrics, West China Second University Hospital, 
      Sichuan University, Chengdu, China.
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children 
      (Sichuan University), Ministry of Education, Chengdu, China.
FAU - Qiu, Yuxuan
AU  - Qiu Y
AD  - Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan 
      University, Chengdu, China.
FAU - Yu, Esther Dawen
AU  - Yu ED
AD  - MOHH Holdings, Singapore City, Singapore.
FAU - Xiang, Shang
AU  - Xiang S
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
FAU - Meng, Rui
AU  - Meng R
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
FAU - Niu, Kai Fan
AU  - Niu KF
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
FAU - Zhu, Huili
AU  - Zhu H
AUID- ORCID: 0000-0003-2369-0123
AD  - Department of Gynecology and Obstetrics, West China Second University Hospital, 
      Sichuan University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children 
      (Sichuan University), Ministry of Education, Chengdu, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200128
PL  - Denmark
TA  - Am J Reprod Immunol
JT  - American journal of reproductive immunology (New York, N.Y. : 1989)
JID - 8912860
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Abortion, Spontaneous/*drug therapy
MH  - Animals
MH  - Antiphospholipid Syndrome/*drug therapy
MH  - Aspirin/*therapeutic use
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Live Birth
MH  - Pregnancy
MH  - Recurrence
OTO - NOTNLM
OT  - antiphospholipid syndrome
OT  - aspirin
OT  - birthweight
OT  - heparin
OT  - live birth rate
OT  - miscarriages
OT  - recurrent pregnancy loss
EDAT- 2019/12/25 06:00
MHDA- 2021/01/15 06:00
CRDT- 2019/12/25 06:00
PHST- 2019/10/06 00:00 [received]
PHST- 2019/12/10 00:00 [revised]
PHST- 2019/12/10 00:00 [accepted]
PHST- 2019/12/25 06:00 [pubmed]
PHST- 2021/01/15 06:00 [medline]
PHST- 2019/12/25 06:00 [entrez]
AID - 10.1111/aji.13219 [doi]
PST - ppublish
SO  - Am J Reprod Immunol. 2020 Apr;83(4):e13219. doi: 10.1111/aji.13219. Epub 2020 Jan 
      28.