Key result
The combination of low dose aspirin and low-molecular-weight heparin significantly increased the live birth rate to 69% compared to 41% with low dose aspirin alone in women with recurrent miscarriages.
Why the study?
Does the combination of low dose aspirin and low-molecular-weight heparin improve live birth rates and reduce miscarriages in pregnant women with recurrent miscarriages compared to low dose aspirin alone?
RCT (n=150)
Open-label
Computer generated numbers drawn from an envelope
No
Does the combination of low dose aspirin and low-molecular-weight heparin improve live birth rates and reduce miscarriages in pregnant women with recurrent miscarriages compared to low dose aspirin alone?
Absolute Event Rate: 69% vs 41%
p-value: p=<0.001
In pregnant women with a history of recurrent miscarriages, combining low-molecular-weight heparin with low-dose aspirin significantly increased live birth rates and reduced miscarriages compared to aspirin alone.
Supports adding low-molecular-weight heparin to aspirin in recurrent miscarriage; confirms benefit on live birth rates in this population.
BACKGROUND: Recurrent miscarriage is a major women's health problem. Aspirin and heparin have been shown to have potentially beneficial effects on trophoblast implantation. However, few published data on this issue are available from developing countries. No significant side effects of the treatments could be evidenced in patients or newborns with both drugs. METHODS: An open clinical trial was conducted at the Department of Obstetrics and Gynecology at KIMSDU, Karad from January 2011 to December 2012 to investigate the effects of treatment with low dose aspirin (LDA) versus treatment with low-molecular-weight-heparin (LMWH) in combination with LDA on patients with a history of recurrent miscarriages. A total of 150 women were enrolled in the study. Women were eligible for the study if they had a history of three or more consecutive miscarriages. Participants were randomly assigned to receive either LDA (75 mg daily) alone or a combination of LDA and LMWH (75 women per treatment group). The primary outcomes were the rate of miscarriages and live births for each group. RESULTS: Compared with the group who received LDA alone, the combination group had a significantly lower number of miscarriages (24/75 [32%] vs. 41/75 [54%], P < 0.001) and had a significantly higher number of live births (52/75 [69%] vs. 31/75 [41%], P< 0.001). Two preterm infants in the LDA group and three in the combination group were admitted to the neonatal intensive care unit. There were no significant differences in the mean (SD) birth weights of neonates born in either group (2950.4 565 vs. 3000 540 g for the LDA and combination groups, respectively, P = 0.444). There were no congenital abnormalities detected in either group. CONCLUSION: The combination of LDA and LMWH is better than LDA alone for the maintenance of pregnancy in patients with recurrent first trimester miscarriage.
No takes yet. Share an insight, caveat, or question.
Laddad et al. (2014) conducted an RCT in Recurrent miscarriages (n=150). Low dose aspirin and low-molecular-weight heparin vs. Low dose aspirin alone (75 mg daily) was evaluated on Live births (p=<0.001). The combination of low dose aspirin and low-molecular-weight heparin significantly increased the live birth rate to 69% compared to 41% with low dose aspirin alone in women with recurrent miscarriages.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: