Document Detail


Use of intravenous immunoglobulin for treatment of recurrent miscarriage: a systematic review.
MedLine Citation:
PMID:  17166218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intravenous immunoglobulin (IVIG) is a fractionated blood product whose off-label use for treating a variety of conditions, including spontaneous recurrent miscarriage, has continued to grow in recent years. Its high costs and short supply necessitate improved guidance on its appropriate applications. OBJECTIVE: We conducted a systematic review of randomised controlled trials evaluating IVIG for treatment of spontaneous recurrent miscarriage. SEARCH STRATEGY: A systematic search strategy was applied to Medline (1966 to June 2005) and the Cochrane Register of Controlled Trials (June 2005). SELECTION CRITERIA: We included all randomised controlled trials comparing all dosages of IVIG to placebo or an active control. DATA COLLECTION AND ANALYSIS: Two investigators independently extracted data using a standardised data collection form. Measures of effect were derived for each trial independently, and studies were pooled based on clinical and methodologic appropriateness. MAIN RESULTS: We identified eight trials involving 442 women that evaluated IVIG therapy used to treat recurrent miscarriage. Overall, IVIG did not significantly increase the odds ratio (OR) of live birth when compared with placebo for treatment of recurrent miscarriage (OR 1.28, 95% CI 0.78-2.10). There was, however, a significant increase in live births following IVIG use in women with secondary recurrent miscarriage (OR 2.71, 95% CI 1.09-6.73), while those with primary miscarriage did not experience the same benefit (OR 0.66, 95% CI 0.35-1.26). AUTHOR'S CONCLUSIONS: IVIG increased the rates of live birth in secondary recurrent miscarriage, but there was insufficient evidence for its use in primary recurrent miscarriage.
Authors:
B Hutton; R Sharma; D Fergusson; A Tinmouth; P Hebert; J Jamieson; M Walker
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2006-12-12
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  114     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-19     Completed Date:  2007-03-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  134-42     Citation Subset:  AIM; IM    
Affiliation:
Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa Hospital, and Department of Psychology, Lakehead University, Thunder Bay, Canada.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / etiology,  therapy*
Antiphospholipid Syndrome / complications,  therapy
Birth Weight
Female
Gestational Age
Humans
Immunoglobulins, Intravenous / therapeutic use*
Pregnancy
Pregnancy Outcome
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Immunoglobulins, Intravenous

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