Cochrane · systematic review · CD012852
Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss
Hamulyák, EN, Scheres, LJJ, Marijnen, MC, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
13
No studies
2
Included studies
NR
No studies 2 · 10%Ungraded 5 · 25%Very low 9 · 45%Low 4 · 20%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Aspirin compared to placebo for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss
Population: improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth Aspirin vs placebo | RR 0.94 [0.71, 1.25] | 1 study · 40 participants | Very low Downgraded: risk of bias |
Pre‐eclampsia Aspirin vs placebo | RR 1.06 [0.25, 4.52] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Adverse events in the mother ‐ Bleeding Aspirin vs placebo | RR 1.29 [0.6, 2.77] | 1 study · 40 participants | Very low Downgraded: risk of bias |
Venous thromboembolism Aspirin vs placebo | no estimate extracted | NR | No studies |
Arterial thromboembolism Aspirin vs placebo | no estimate extracted | NR | No studies |
Pregnancy loss Aspirin vs placebo | RR 1.33 [0.34, 5.21] | 1 study · 40 participants | Very low Downgraded: risk of bias |
Preterm delivery of a live infant Aspirin vs placebo | RR 5.29 [0.27, 102.49] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Intrauterine growth restriction Aspirin vs placebo | RR 0.27 [0.03, 2.13] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Adverse events in the child ‐ Congenital malformations Aspirin vs placebo | RR 1.06 [0.07, 15.6] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Heparin plus aspirin compared to aspirin for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss
Population: women with persistent antiphospholipid antibodies and recurrent pregnancy loss
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth Heparin plus aspirin vs aspirin | RR 1.27 [1.09, 1.49] | 5 studies · 1295 participants | Low Downgraded: risk of bias |
Pre‐eclampsia Heparin plus aspirin vs aspirin | RR 0.57 [0.1, 3.14] | 2 studies · 82 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events in the mother ‐ Bleeding Heparin plus aspirin vs aspirin | RR 1.65 [0.19, 14.03] | 1 study · 31 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events in the mother ‐ Heparin‐induced thrombocytopenia Heparin plus aspirin vs aspirin | no estimate extracted | 2 studies · 140 participants | Ungraded |
Adverse events in the mother ‐ Allergic reactions Heparin plus aspirin vs aspirin | no estimate extracted | 1 study · 90 participants | Ungraded |
Venous thromboembolism Heparin plus aspirin vs aspirin | no estimate extracted | 3 studies · 182 participants | Ungraded |
Arterial thromboembolism Heparin plus aspirin vs aspirin | no estimate extracted | 3 studies · 182 participants | Ungraded |
Pregnancy loss Heparin plus aspirin vs aspirin | RR 0.48 [0.32, 0.71] | 5 studies · 1295 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Preterm delivery of a live infant Heparin plus aspirin vs aspirin | RR 0.93 | 3 studies · 156 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Intrauterine growth restriction Heparin plus aspirin vs aspirin | RR 0.85 [0.33, 2.19] | 3 studies · 151 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events in the child ‐ Congenital malformations Heparin plus aspirin vs aspirin | no estimate extracted | 1 study · 51 participants | Ungraded |