Key result
Enoxaparin treatment was associated with a higher live birth rate in women with recurrent miscarriages, where factor V Leiden (20.9%) was the most common thrombophilia.
Why the study?
Does antithrombotic treatment with enoxaparin improve live birth rates in pregnant women with recurrent miscarriages?
Cohort (n=490)
No
Does antithrombotic treatment with enoxaparin improve live birth rates in pregnant women with recurrent miscarriages?
Enoxaparin therapy may improve live birth rates in women with recurrent miscarriages, particularly those with four or more prior losses, regardless of underlying thrombophilia status.
Answers are grounded in this paper and cite their sources.
May support enoxaparin in recurrent miscarriage with ≥4 losses; hypothesis-generating and requires randomized confirmation.
OBJECTIVE: To estimate the prevalence of thrombophilia in women with recurrent miscarriages and to assess the effect of antithrombotic therapy. DESIGN: A retrospective cohort study between the years 2004 and 2010. SETTING: A hypercoagulation community clinic in northern Israel. PATIENTS: Four hundred ninety pregnant women referred for thrombophilia screening. MAIN OUTCOME MEASURES: Screening results for thrombophilia and antithrombotic treatment with enoxaparin, aspirin, or both and pregnancy outcomes. RESULTS: The most common thrombophilia in our study group was factor V Leiden mutation with a prevalence of 20.9% followed by protein S deficiency with a prevalence of 19%. Live birth rate was higher in the group of women who received enoxaparin regardless of whether a specific thrombophilia could be found. This finding was more pronounced in women who had ≥4 miscarriages. CONCLUSION: The prevalence of thrombophilia was higher in our study group than in the general population. Furthermore, treatment with enoxaparin might improve the rate of live births in women with or without evidence of thrombophilia, especially in women with ≥4 miscarriages.
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Nahas et al. (2016) conducted a cohort in Recurrent miscarriages (n=490). Enoxaparin vs. No enoxaparin was evaluated on Live birth rate. Enoxaparin treatment was associated with a higher live birth rate in women with recurrent miscarriages, where factor V Leiden (20.9%) was the most common thrombophilia.
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