title: The effect of intravenous immunoglobulin passive immunotherapy on unexplained recurrent spontaneous abortion: a meta-analysis.
abstract: The aim of this study was to investigate the effect of passive immunotherapy using intravenous immunoglobulin (IVIG) on unexplained recurrent spontaneous abortion (RSA). Live birth rates were analysed and binary data were calculated using risk ratio and 95% confidence interval. Meta-analysis of 11 studies showed that the difference in the live birth rate between the IVIG treatment and placebo groups was on the margin of significance (RR = 1.25, 95% CI 1.00 to 1.56, P = 0.05). Both cumulative and trial sequential meta-analyses indicated potential beneficial effect of IVIG but the evidence was inconclusive. Subgroup analysis showed that the live birth rate in primary (RR = 0.88, 95% CI 0.71 to 1.07) and secondary (RR = 1.26, 95% CI 0.99 to 1.61) RSA patients was not significantly different between the IVIG and placebo groups. Live birth rate was significantly different when IVIG was administered before conception (RR = 1.67, 95% CI 1.30 to 2.14, P < 0.0001) but not after implantation (RR = 1.10, 95% CI 0.93 to 1.29). Evidence is insufficient to support the beneficial effects of IVIG on an unexplained RSA. Further high quality studies are needed to elucidate the effectiveness of IVIG.
authors.affiliation: Department of Pharmacy, The People's Hospital of Quzhou, 2 Zhongloudi Road, Quzhou, Zhejiang 324000, China.
authors.forename: Si-Wei
authors.initials: SW
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, The People's Hospital of Quzhou, 2 Zhongloudi Road, Quzhou, Zhejiang 324000, China. Electronic address: qzzhongsongyang@sina.com.
authors.forename: Song-Yang
authors.initials: SY
authors.lastname: Zhong
authors.affiliation: Department of Pharmacy, The People's Hospital of Quzhou, 2 Zhongloudi Road, Quzhou, Zhejiang 324000, China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Lou
authors.affiliation: Department of Pharmacy, The People's Hospital of Quzhou, 2 Zhongloudi Road, Quzhou, Zhejiang 324000, China.
authors.forename: Ze-Fu
authors.initials: ZF
authors.lastname: Hu
authors.affiliation: Department of Pharmacy, The People's Hospital of Quzhou, 2 Zhongloudi Road, Quzhou, Zhejiang 324000, China.
authors.forename: Hua-Yu
authors.initials: HY
authors.lastname: Sun
authors.affiliation: Department of Pharmacy, The People's Hospital of Quzhou, 2 Zhongloudi Road, Quzhou, Zhejiang 324000, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Zhu
mesh_terms: D000026:Abortion, Habitual / Q000276:immunology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D002681:China; D010064:Embryo Implantation; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: IVIG; meta-analysis; primary RSA; randomized controlled trial; recurrent spontaneous abortion; secondary RSA