Effects of low-dose aspirin and heparin on the pregnancy outcome in women with antiphospholipid syndrome

Baiazid, Latifa; Hraib, Munawar

doi:10.1016/j.amsu.2022.104807

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Therefore, we concluded that LDA or LDA plus LMWH could improve the perinatal outcomes to a certain extent. Similarly, previous studies have reported that, compared with the placebo group, LDA combined with LMWH reduced the rate of miscarriage, increased neonatal weight and improved perinatal outcomes in aPL-positive pregnant women (31)(32)(33). Other studies reported that LAD combined with LMWH improved perinatal outcomes in pregnant women with CH (34).…”

Section: Discussionmentioning

confidence: 61%

Maternal and perinatal outcomes of low-dose aspirin plus low-molecular-weight heparin therapy on antiphospholipid antibody-positive pregnant women with chronic hypertension

Long

Zhang

et al. 2023

Front. Pediatr.

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ObjectivesPositive antiphospholipid antibodies (aPLs) and chronic hypertension (CH) in pregnancy are important causes of maternal and neonatal morbidity and mortality. However, there are no relevant studies on the treatment of aPL-positive pregnant women with CH. This study aimed to determine the effect of low-dose aspirin (LDA) plus low-molecular-weight heparin (LMWH) on maternal and perinatal outcomes in persistently aPL-positive pregnant women with CH.MethodsThis study was performed at the First Affiliated Hospital of Dalian Medical University in Liaoning, China, from January 2018 to December 2021. Pregnant women diagnosed CH and persistently positive aPL who had no autoimmune disease such as systemic lupus erythematosus, antiphospholipid syndrome were recruited and divided into control group (LDA and LWMH were not used), LDA group (LDA was used) and LDA plus LMWH group (both LDA and LMWH were used) according to whether they use LDA and/or LMWH. A total of 81 patients were enrolled, including 40 patients in the control group, 19 patients in the LDA group, and 22 patients in the LDA plus LMWH group. The maternal and perinatal outcomes of LDA plus LMWH therapy were analysed.ResultsCompared with control group, the rate of severe preeclampsia in LDA group (65.00% vs. 31.58%, p = 0.016) and LDA plus LMWH group (65.00% vs. 36.36%, p = 0.030) had a statistically significant reduction. Compared with control group, the rate of fetal loss in LDA group (35.00% vs. 10.53%, p = 0.014) and LDA plus LMWH group (35.00% vs. 0.00%, p = 0.002) had a statistically significant reduction. Compared with control group, the rate of live birth in LDA group (65.00% vs. 89.74%, p = 0.048) and LDA plus LMWH group (65.00% vs. 100.00%, p = 0.002) had a statistically significant increased. Compared withcontrol group, the incidence of early-onset preeclampsia (47.50% vs. 36.84%, p = 0.008) and early-onset severe preeclampsia (47.50% vs. 13.64%, p = 0.001) in the LDA plus LMWH group decreased and were statistically different. Furthermore, we also found that LDA or LDA plus LMWH hadn't increase the rate of blood loss and placental abruption.ConclusionBoth LDA and LDA combined with LMWH could decrease the incidence of severe preeclampsia, decrease the rate of foetal loss, increase the rate of live birth. However, LDA plus LWMH could reduce and delay the onset of severe preeclampsia, prolong the gestational age and increase the rate of full-term delivery, improve the maternal and perinatal outcomes.

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Section: Discussionmentioning

confidence: 61%

Maternal and perinatal outcomes of low-dose aspirin plus low-molecular-weight heparin therapy on antiphospholipid antibody-positive pregnant women with chronic hypertension

Long

Zhang

et al. 2023

Front. Pediatr.

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“…Direct oral anticoagulants like rivaroxaban, apixaban, and dabigatran are utilized for secondary prevention of venous thromboembolism (VTE), although these medications are teratogenic. In pregnant women, accepted treatments include low-molecular-weight heparin (LMWH) and low-dose aspirin [4,[50][51][52].…”

Section: Treatment Options In Apsmentioning

confidence: 99%

Understanding the Pathophysiology of Preeclampsia: Exploring the Role of Antiphospholipid Antibodies and Future Directions

Mitranovici,

Chiorean,

Moraru

et al. 2024

JCM

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Preeclampsia (PE) is a hypertensive disorder in pregnancy associated with significant fetal and maternal complications. Antiphospholipid syndrome (APS) is an acquired form of thrombophilia characterized by recurrent venous or arterial thrombosis and obstetric complications that significantly increases morbidity and mortality rates. While preeclampsia may not be the most prevalent obstetric complication in APS, it significantly impacts the long-term health of both mother and child. The treatment of preeclampsia in antiphospholipid syndrome is different from the treatment of preeclampsia as an independent disease. Despite current treatments involving anticoagulants, antiplatelet agents, and antihypertensive drugs, obstetric complications may persist, underscoring the need for cohesive management and effective treatments. The objective of our review is to briefly present knowledge about the physiopathology of preeclampsia and the role of antiphospholipid antibodies in this process. Based on the existing literature, our review aims to identify future directions in molecular pathology toward the discovery of biomarkers and targeted treatments. The application of multidisciplinary approaches and prognostic models, including new biomarkers, could be beneficial in the prediction of PE.

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“…Additionally, immunoglobulin therapy has been shown to effectively modulate the maternal immune response, further decreasing the risk of miscarriage [127,128]. For the specific condition of antiphospholipid antibody syndrome, the use of heparin combined with low-dose aspirin as a treatment strategy has been demonstrated to effectively reduce the risk of miscarriage [129,130]. Moreover, studies related to complex regional pain syndrome have pointed out that the induction of TNF-α and IL-1β might be associated with recurrent miscarriages [131].…”

Section: Treatment Strategiesmentioning

confidence: 99%

Inflammation in recurrent miscarriage — a comprehensive perspective from uterine microenvironment and immune cell imbalance to therapeutic strategies

Lin,

Xu,

Qiu

2024

Ginekol Pol

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Recurrent miscarriage, poses a significant challenge for many couples globally, the causes of which are not fully understood. Recent studies have shown the intricate link between uterine inflammation and recurrent miscarriages. While inflammation is essential during early pregnancy stages, especially in embryo implantation, an imbalance can lead to miscarriage. Key inflammatory mediators and an imbalance in immune cells can significantly alter and contribute to recurrent miscarriages. Lifestyle factors like smoking and obesity exacerbate inflammatory responses, increasing miscarriage risks. Understanding the interaction between the uterine environment, immune cell imbalances, and recurrent miscarriages is essential for devising effective treatments. This paper presents the latest data on inflammation's role in recurrent miscarriage, emphasizing the significance of diagnosing chronic endometritis and immune imbalances, offering practical recommendations for treatment and diagnosis.

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Effects of low-dose aspirin and heparin on the pregnancy outcome in women with antiphospholipid syndrome

Cited by 3 publications

References 17 publications

Maternal and perinatal outcomes of low-dose aspirin plus low-molecular-weight heparin therapy on antiphospholipid antibody-positive pregnant women with chronic hypertension

Maternal and perinatal outcomes of low-dose aspirin plus low-molecular-weight heparin therapy on antiphospholipid antibody-positive pregnant women with chronic hypertension

Understanding the Pathophysiology of Preeclampsia: Exploring the Role of Antiphospholipid Antibodies and Future Directions

Inflammation in recurrent miscarriage — a comprehensive perspective from uterine microenvironment and immune cell imbalance to therapeutic strategies

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