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.
Vaquero
E
E
Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Fatebenefratelli Hospital, Isola Tiberina, Italy.
Lazzarin
N
N
Valensise
H
H
Menghini
S
S
Di Pierro
G
G
Cesa
F
F
Romanini
C
C
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