Pregnancy Outcome in Recurrent Spontaneous Abortion Associated with Antiphospholipid Antibodies: A Comparative Study of Intravenous Immunoglobulin Versus Prednisone Plus Low-Dose Aspirin

Authors

  • ELENA VAQUERO,

  • HERBERT VALENSISE,

  • SIMONA MENGHINI,

  • GIUSEPPE DI PIERRO,

  • CARLO ROMANINI,

  • NATALIA LAZZARIN,

  • FABRIZIO CESA


Address reprint requests to Elena Vaquero, M.D., Department of Obstetrics and Gynecology, Ospedale Fatebenefratelli, Isola Tiberina, Rome, Italy.

Abstract

PROBLEM: To compare the use of intravenous immunoglobulins (IVIG) with prednisone plus low-dose aspirin (LDA) in treating pregnant women with a history of recurrent fetal loss having the antiphospholipid antibody (aPL), in terms of live-birth rate and maternal and perinatal morbidity.
METHOD: A prospective, two-centers trial study included 82 recurrent aborters with aPL syndrome. Twenty-nine were treated with prednisone and LDA in one center, 53 received IVIG in the other center. Maternal and fetal outcomes and pregnancy complications were compared between groups.
RESULTS: Live-birth rates were equivalent between groups (78 vs 76%). Mean birth weight was higher in the IVIG group than in the prednisone plus LDA group. In the prednisone- plus LDA-treated patients, gestational hypertension and gestational diabetes were found significantly more often than in the IVIG-treated group (14 vs 5% and 14 vs 5%, respectively).
CONCLUSION: In patients with aPL syndrome, IVIG treatment improved pregnancy outcome, with significantly lower pregnancy complication rates, when compared with prednisone plus LDA therapy.

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