Spegiorin L C J F, Galão E A, De Godoy J M P, Bagarelli L B, Oliani A H
Department of the Gynaecology and Obstetrics of the Medical School, São José do Rio Preto, SP, Brazil.
Prague Med Rep. 2007;108(2):185-90.
The aim of this study was to evaluate the efficacy of prophylaxis using low-dose non-fractioned heparin and aspirin in the prevention of intrauterine growth restriction and low birth weights in patients suffering from antiphospholipid antibody syndrome. Intrauterine growth retardation and birth weights of 34 gestations involving 28 women with histories of multiple miscarriages and elevated antiphospholipid antibody levels were evaluated in a prospective study in the period from April 1988 to July 2004. A control group was formed of 39 women without previous history of miscarriages over a total of 40 gestations. Intrauterine growth retardation was considered when the weight of the newborn baby was below the tenth percentile for gestational age according to the fetal weight chart. Diagnosis of antiphospholipid antibodies was achieved using the ELIZA test to measure the IgG and IgM immunoglobulin levels. Evaluation of lupus anticoagulant was performed using the activated partial thromboplastin time (aPTT). Women suffering from antiphospholipid antibodies underwent prophylactic treatment during gestation with low doses of acetylsalicylic acid (100 mg daily) associated to low doses of subcutaneous heparin (5000 IU twice daily). The non-paired Student t-test, Fisher Exact and Mann-Whitney tests were used for statistical analysis with an a error of up to 5% considered acceptable. A statistically higher number of newborns suffered intrauterine growth retardation and low birth weights in the study group than in the control group. In conclusion, children of mothers suffering from antiphospholipid antibody syndrome, even those undergoing prophylactic treatment with low-dose non-fractioned heparin and aspirin, are associated to intrauterine growth retardation and low birth weights.
本研究的目的是评估使用低剂量普通肝素和阿司匹林进行预防，对患有抗磷脂抗体综合征的患者预防宫内生长受限和低出生体重的疗效。在1988年4月至2004年7月期间的一项前瞻性研究中，对28名有多次流产史且抗磷脂抗体水平升高的女性的34次妊娠的宫内生长发育迟缓情况及出生体重进行了评估。对照组由39名无流产史女性的40次妊娠组成。根据胎儿体重图表，当新生儿体重低于其孕周的第十百分位数时，视为发生宫内生长迟缓。使用酶联免疫吸附测定（ELISA）试验测量IgG和IgM免疫球蛋白水平来诊断抗磷脂抗体。采用活化部分凝血活酶时间（aPTT）评估狼疮抗凝物。患有抗磷脂抗体的女性在妊娠期接受低剂量乙酰水杨酸（每日100毫克）联合低剂量皮下肝素（每日两次，每次5000国际单位）的预防性治疗。采用非配对学生t检验、Fisher精确检验和Mann-Whitney检验进行统计分析，α误差高达5%被认为是可接受的。研究组中发生宫内生长迟缓及低出生体重的新生儿数量在统计学上高于对照组。总之，患有抗磷脂抗体综合征的母亲所生的孩子，即使是那些接受低剂量普通肝素和阿司匹林预防性治疗的孩子，也与宫内生长迟缓及低出生体重有关。
