Please use this identifier to cite or link to this item: https://doi.org/10.1093/rheumatology/kep373
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dc.titleCombination of heparin and aspirin is superior to aspirin alone in enhancing live births in patients with recurrent pregnancy loss and positive anti-phospholipid antibodies: A meta-analysis of randomized controlled trials and meta-regression
dc.contributor.authorMak, A.
dc.contributor.authorCheung, M.W.-L.
dc.contributor.authorCheak, A.A.-C.
dc.contributor.authorChun-Man Ho, R.
dc.date.accessioned2014-04-03T05:20:58Z
dc.date.available2014-04-03T05:20:58Z
dc.date.issued2009-12-04
dc.identifier.citationMak, A., Cheung, M.W.-L., Cheak, A.A.-C., Chun-Man Ho, R. (2009-12-04). Combination of heparin and aspirin is superior to aspirin alone in enhancing live births in patients with recurrent pregnancy loss and positive anti-phospholipid antibodies: A meta-analysis of randomized controlled trials and meta-regression. Rheumatology 49 (2) : 281-288. ScholarBank@NUS Repository. https://doi.org/10.1093/rheumatology/kep373
dc.identifier.issn14620324
dc.identifier.urihttp://scholarbank.nus.edu.sg/handle/10635/49974
dc.description.abstractObjective. The combination of heparin and aspirin was regarded as the 'standard therapy' for patients with recurrent pregnancy loss (RPL) and positive aPL antibodies to enhance live births, but it largely stems from expert opinion. We performed a meta-analysis of randomized controlled trials (RCTs) to assess whether this combination works better than aspirin alone. Methods. RCTs testing the efficacy of a combination of heparin and aspirin vs aspirin alone in patients with RPL and positive aPL antibodies were identified in electronic databases. Random effect meta-analysis was employed to pool relative risks (RRs) (with 95% CI) of live births as the primary outcome. RRs of obstetrical complications and standardized mean difference of birth weight were the secondary outcomes. Mixed-effects meta-regression was performed to identify factors associated with live births. Results. Data from five trials involving 334 patients were analysed. The overall live birth rates were 74.27 and 55.83% in the combination and aspirin alone groups, respectively. Patients who received heparin and aspirin had significantly higher live birth rate (RR 1.301; 95% CI 1.040, 1.629) than aspirin alone, with the number needed to achieve one live birth being 5.6. No significant differences in pre-eclampsia, preterm labour and birth weight were found between both the groups. Meta-regression using age at randomization, previous history of live births and episodes of miscarriages as covariates failed to predict the RR of live birth. Conclusions. The combination of heparin and aspirin is superior to aspirin alone in achieving more live births in patients with positive aPL antibodies and RPL. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology.
dc.sourceScopus
dc.subjectAnti-phospholipid antibody syndrome
dc.subjectAspirin
dc.subjectEgger's regression
dc.subjectHeparin
dc.subjectLive births
dc.subjectMeta-analysis
dc.subjectMeta-regression
dc.subjectObstetrical
dc.typeArticle
dc.contributor.departmentPSYCHOLOGY
dc.contributor.departmentMEDICINE
dc.contributor.departmentPSYCHOLOGICAL MEDICINE
dc.description.doi10.1093/rheumatology/kep373
dc.description.sourcetitleRheumatology
dc.description.volume49
dc.description.issue2
dc.description.page281-288
dc.description.codenRUMAF
dc.identifier.isiut000273699700011
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