■低分子量肝素(LMWH)预防原因不明的复发性妊娠流产的有效性仍存在争议。为了探讨LMWH治疗在不明原因复发性妊娠丢失中的作用,我们进行了这项荟萃分析.
■我们搜索了四个数据库PubMed,科克伦图书馆,EMBASE,和临床试验(截至2020年2月)用于随机对照试验(RCT),评估LMWH治疗复发性流产的有效性。我们使用Stata软件进行荟萃分析。此外,我们根据复发性流产的定义(如2次或更多次流产或3次或更多次流产)对敏感性和预定义亚组进行分析,以寻找异质性来源.
■5项研究符合选择标准,涉及1452名参与者。LMWH可降低≥3次流产女性的流产风险(RR=0.46;95%CI=0.35-0.61,p=.00),但LMWH并未降低2次以上流产女性的流产风险(RR=0.70;95%CI=0.57-0.86,p=0.26).未发现对活产率的实质性影响(RR=1.19;95%CI=0.99-1.43),早产(RR=0.95;95%CI=0.65-1.38),先兆子痫(RR=0.89,95%CI=0.45-1.76),小于胎龄(RR=0.89;95%CI=0.64-1.51)。
■LMWH治疗可能会降低有3次或更多次流产史的女性的流产率,但并不能减少有2次或2次以上流产史的女性流产的发生率。我们需要更多的RCT来提供可靠可靠的结果。
UNASSIGNED: The effectiveness of low molecular weight heparin (
LMWH) in preventing miscarriage of unexplained recurrent pregnancy loss remains controversial. In order to explore the effect of
LMWH therapy in unexplained recurrent pregnancy loss, we conducted this meta-analysis.
UNASSIGNED: We searched four databases PubMed, Cochrane Library, EMBASE, and Clinical Trials.gov (up to February 2020) for the randomized control trials (RCTs) evaluating the effectiveness of LMWH on the treatment of recurrent miscarriage. We used Stata software to perform a meta-analysis. Moreover, we performed analyses of sensitivity and predefined subgroups based on the definition of recurrent miscarriage (e.g. 2 or more miscarriages or 3 or more miscarriages) to search the source of heterogeneity.
UNASSIGNED: 5 studies met the selection criteria, involving 1452 participants.
LMWH reduce the risk of miscarriage of women suffering ≥3 miscarriages (RR = 0.46; 95% CI = 0.35-0.61, p = .00), but the risk of miscarriage of women suffering ≥2 miscarriages was not decreased by
LMWH (RR = 0.70; 95% CI = 0.57-0.86, p = .26). No substantial influence was found on Live birth rate (RR = 1.19; 95% CI = 0.99-1.43), Preterm birth (RR = 0.95; 95% CI = 0.65-1.38), Preeclampsia (RR = 0.89, 95% CI = 0.45-1.76), Small for gestational age (RR = 0.89; 95% CI = 0.64-1.51).
UNASSIGNED: LMWH treatment may decrease the miscarriage rate in women suffering a history of 3 or more miscarriages, but not reduce the incidence of miscarriage in women suffering a history of 2 or more miscarriages. We need more RCTs to provide robust and reliable results.