对有或无遗传性血栓形成倾向的复发性妊娠丢失患者进行持针：荟萃分析和文献复习。
Hold your needles in women with recurrent pregnancy losses with or without hereditary thrombophilia: Meta-analysis and review of the literature.
机构信息
Democritus University of Thrace, Medical School, Department of Hematology, Greece.
Democritus University of Thrace, Medical School, Department of Hematology, Greece.
出版信息
J Gynecol Obstet Hum Reprod. 2021 Apr;50(4):101935. doi: 10.1016/j.jogoh.2020.101935. Epub 2020 Oct 6.
OBJECTIVES
The use of antithrombotic prophylaxis in women with recurrent pregnancy losses (RPL) remains controversial.
METHODS
We performed meta-analysis of randomized controlled trials (RCTs) comparing low molecular weight heparin (LMWH) versus No LMWH in women with or without hereditary thrombophilia and RPL. Twelve RCTs met our inclusion criteria and 2298 women were included in this meta-analysis. Our primary end point was live birth and odds ratio (OR) for live birth are reported.
RESULTS
In women with thrombophilia the benefit of LMWH on live birth is not significant but heterogeneity of the studies is significant (OR, 2.09; 95 % CI, 0.58-7.57; p = 0.26; I = 86 %, p = 0.0001). Considering women without thrombophilia there is no benefit of LMWH in OR of live birth and data from studies have low heterogeneity (OR, 1.25; 95 % CI, 0.88-1.78; p = 0 0.21; I = 44 %, p = 0.07).
CONCLUSIONS
Hold your needles in women with RPL. Probably in some hereditary thrombophilic defects LMWH has a positive effect on OR for live birth.
目的
在复发性妊娠丢失（RPL）女性中使用抗血栓预防措施仍存在争议。
方法
我们对比较低分子肝素（LMWH）与无 LMWH 在有或无遗传性血栓形成倾向和 RPL 的女性中的随机对照试验（RCT）进行了荟萃分析。符合纳入标准的 12 项 RCT 共纳入 2298 名女性。我们的主要终点是活产，报告活产的优势比（OR）。
结果
在血栓形成倾向的女性中，LMWH 对活产的获益并不显著，但研究的异质性显著（OR，2.09；95%CI，0.58-7.57；p = 0.26；I = 86%，p = 0.0001）。考虑无血栓形成倾向的女性，LMWH 对活产的 OR 没有获益，且研究数据异质性较低（OR，1.25；95%CI，0.88-1.78；p = 0.21；I = 44%，p = 0.07）。
结论
在 RPL 女性中慎用针剂。可能在某些遗传性血栓形成倾向缺陷中，LMWH 对活产的 OR 有积极影响。
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