Pregnancy outcome in recurrent spontaneous abortion associated with antiphospholipid antibodies: a comparative study of intravenous immunoglobulin versus prednisone plus low-dose aspirin.
OBJECTIVE
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.


METHODS
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).


CONCLUSIONS
In patients with aPL syndrome, IVIG treatment improved pregnancy outcome, with significantly lower pregnancy complication rates, when compared with prednisone plus LDA therapy.
Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Fatebenefratelli Hospital, Isola Tiberina, Italy.
E
E
Vaquero
N
N
Lazzarin
H
H
Valensise
S
S
Menghini
G
G
Di Pierro
F
F
Cesa
C
C
Romanini
D000026:Abortion, Habitual / Q000188:drug therapy* / Q000276:immunology*; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome
D017152:Antibodies, Antiphospholipid; D016756:Immunoglobulins, Intravenous; D001241:Aspirin; D011241:Prednisone