| Recurrent miscarriage and antiphospholipid antibodies: prognosis of subsequent pregnancy. | |
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MedLine Citation:
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PMID: 20704646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although women with antiphospholipid antibodies (APLAs) are at increased risk of recurrent miscarriage, the outcome of a subsequent pregnancy is not clearly elucidated. OBJECTIVES: To assess the pregnancy outcome of a subsequent pregnancy in women with APLAs and compare this outcome with women with unexplained recurrent miscarriage. METHODS: We performed a cohort study among all women who attended the Miscarriage Clinic at Liverpool Women's Hospital between 1987 and 2006 after being referred due to recurrent miscarriage (≥2 consecutive pregnancy losses). All women underwent a standardized investigation sequence. Women with other reasons for recurrent miscarriage were excluded. RESULTS: A total of 693 women fulfilled the selection criteria, of whom 176 (25%) had APLAs. One hundred and twenty-two (69%) women with APLAs had a subsequent live birth compared with 324 (63%) women with unexplained recurrent miscarriage (OR 1.3, 95% CI 0.9-1.9). No differences were found for birth weight, gestational age, and intra-uterine growth restriction. When treatment was analyzed, 53/67 (79%) of women with APLAs who had received aspirin and heparin during their pregnancy had a live birth, compared with 64/104 (62%) of women with APLAs who received aspirin only (adjusted OR 2.7, 95% CI 1.3-5.8). In unexplained recurrent miscarriage, stratification for treatment showed no differences in outcome. CONCLUSION: The prognosis of a subsequent pregnancy in women with APLAs is good. Although this was not a randomized clinical trial, combined treatment of aspirin and heparin seemed associated with a better outcome in women with APLAs, but not in women with unexplained recurrent miscarriage. |
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Authors:
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D M Cohn; M Goddijn; S Middeldorp; J C Korevaar; F Dawood; R G Farquharson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of thrombosis and haemostasis : JTH Volume: 8 ISSN: 1538-7836 ISO Abbreviation: J. Thromb. Haemost. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-28 Completed Date: 2011-03-07 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 101170508 Medline TA: J Thromb Haemost Country: England |
Other Details:
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Languages: eng Pagination: 2208-13 Citation Subset: IM |
Copyright Information:
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© 2010 International Society on Thrombosis and Haemostasis. |
Affiliation:
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Department of Internal Medicine, Academic Medical Center Center, University of Amsterdam, the Netherlands. d.m.cohn@amc.uva.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Habitual
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immunology*,
prevention & control* Adult Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Antibodies, Antiphospholipid / immunology* Anticoagulants / therapeutic use Aspirin / therapeutic use Female Heparin / therapeutic use Humans Odds Ratio Pregnancy Pregnancy Complications Pregnancy Outcome Prognosis |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL058869-10/HL/NHLBI NIH HHS; R01 HL065500-08/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antibodies, Antiphospholipid; 0/Anticoagulants; 50-78-2/Aspirin; 9005-49-6/Heparin |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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