Analysis of Treatment and Subsequent Pregnancy Outcomes in Patients With Antinuclear Antibody-Positive Recurrent Spontaneous Abortion.

BACKGROUND

The etiology of recurrent spontaneous abortion (RSA) has not been clearly defined. The role of autoantibodies in RSA has particularly attracted much attention.

OBJECTIVE

A retrospective analysis was performed to explore the combinatory efficacy of five drugs (aspirin enteric-coated tablets, hydroxychloroquine sulfate, methylprednisolone tablets, calcitriol capsules, and vitamin D calcium) in treating RSA patients with antinuclear antibody (ANA)-positive but could not be diagnosed with autoimmune diseases (AID) through assessment of treatment-related impact on subsequent pregnancy outcomes and adverse reactions.

METHOD OF THE STUDY

Patients who took medication regularly were defined as the observation group (125 cases), and patients who did not take medication or took medication less than 1 month as the control group (86 cases). According to the ANA titer, patients were further divided into subgroups of 1:100, 1:320, and 1:1000, respectively.

RESULTS

Comparison of the observation and the control groups without ANA subgrouping showed that the live birth rate in the observation group was higher (odds ratio 3.312, p < 0.001), and the miscarriage rate was lower than that of the control group (odds ratio 0.302, p < 0.001). Statistically significant results were obtained in ANA titer 1:100 subgrouping (p < 0.001). There was no significant difference between the observation groups and the control groups for the ANA titers 1:320 and 1:1000. No statistically significant differences were observed in pregnancy rate, birthweight, neonatal 1-min Apgar score, and incidence of pregnancy complications between the observation and the control groups. Besides, the treatment showed a low incidence of adverse effects.

CONCLUSION

In summary, RSA patients who are ANA positive (titer 1:100) but not yet diagnosed as AID can have improved pregnancy outcomes after treatment.