Pregnancy outcome in recurrent spontaneous abortion associated with antiphospholipid antibodies: A comparative study of intravenous immunoglobulin versus prednisone plus low-dose aspirin

PROBLEM: To compare the use of intravenous immunoglobulins (IVIG) with pred nisone plus low-dose aspirin (LDA) in treating pregnant women with a histor y of recurrent fetal loss having the antiphospholipid antibody (aPL), in te rms of live-birth rate and maternal and perinatal morbidity. METHOD: A prospective, two-centers trial study included 82 recurrent aborte rs with aPL syndrome. Twenty-nine were treated with prednisone and LDA in o ne center, 53 received IVIG in the other center. Maternal and fetal outcome s and pregnancy complications were compared between groups. RESULTS: Live-birth rates were equivalent between groups (78 vs 76%). Mean birth weight was higher in the IVIG group than in the prednisone plus LDA g roup. In the prednisone- plus LDA-treated patients, gestational hypertensio n and gestational diabetes were found significantly more often than in the IVIG-treated group (14 vs 5% and 14 vs 5%, respectively). CONCLUSION: In patients with aPL syndrome, IVIG treatment improved pregnanc y outcome, with significantly lower pregnancy complication rates, when comp ared with prednisone plus LDA therapy.