Two drugs that have been used for a long time can help women at high risk of miscarriage and other pregnancy complications. Scientists in Japan have found evidence in a small study that low-dose aspirin, either alone or in combination with heparin (a common blood thinner), can prevent some types of recurrent pregnancy loss.
Miscarriage (pregnancy loss in the first twenty weeks of pregnancy) is a common occurrence, affecting 10% to 20% of known pregnancies. But a very small percentage of women, less than 5%, have repeated miscarriages, defined as two or more in a row. A team of researchers at Kobe University and elsewhere in Japan now believe they have found a way to prevent at least some of these tragic events.
In their previous work, the team found that many women with recurrent miscarriages—about 20%—carry antibodies that target a specific protein found on the surface of many cells, including the cells of the uterus that are important for supporting the pregnancy, known as beta-2-glycoprotein I (β2GPI ). Some studies have shown that anti-beta-2-GPI antibodies may play a role in causing antiphospholipid syndrome (APS), an autoimmune disease known to raise the risk of pregnancy loss. But researchers have also found that some women with repeated pregnancies can carry the same antibodies that target beta-2-GPI even without having APS.
Low-dose aspirin, often used alongside heparin, is thought to help reduce the risk of miscarriage in women with APS. So the researchers tested whether the same preventive treatment could help women without APS who had these anti-beta-2-GPI antibodies.
Their research, published Wednesday in the journal Frontiers in Immunologyincluded 47 pregnant women with recurrent pregnancies who tested positive for previously acquired antibodies. Of these, 39 were given low-dose aspirin and/or heparin, while eight were not. Overall, more than 80% of women in the treatment group had a live birth, compared to 50% of the untreated group; these women also had a significantly lower risk of other pregnancy complications.
“The sample size was small, but the results still clearly show that treatment with low-dose aspirin or heparin is very effective in preventing pregnancy or complications even in women with these antibodies,” the lead study said. researcher Tanimura Kenji, an obstetrician at Kobe University, in a statement from the university.
Some women who had these antibodies tested positive for APS, which may have complicated the results. But the researchers found that women without APS had an even higher rate of successful pregnancy when treated with these drugs (over 92%). Kenji notes that anti-beta-2-GPI antibodies can also help prevent infertility and other health conditions in women, such as arterial thrombosis, so their findings could have broader implications there.
In any case, more research and larger trials will be needed to confirm this work. But given how difficult repeated miscarriages can be for the mother and family, finding simple, inexpensive preventative treatments for these conditions can be a wonderful thing.