Analysis of Treatment and Subsequent Pregnancy Outcomes in Patients With Antinuclear Antibody-Positive Recurrent Spontaneous Abortion.

BACKGROUND

The etiology of recurrent spontaneous abortion (RSA) has not been clearly defined. The role of autoantibodies in RSA has particularly attracted much attention.

OBJECTIVE

A retrospective analysis was performed to explore the combinatory efficacy of five drugs (aspirin enteric-coated tablets, hydroxychloroquine sulfate, methylprednisolone tablets, calcitriol capsules, and vitamin D calcium) in treating RSA patients with antinuclear antibody (ANA)-positive but could not be diagnosed with autoimmune diseases (AID) through assessment of treatment-related impact on subsequent pregnancy outcomes and adverse reactions.

METHOD OF THE STUDY: Patients who took medication regularly were defined as the observation group (125 cases), and patients who did not take medication or took medication less than 1 month as the control group (86 cases). According to the ANA titer, patients were further divided into subgroups of 1:100, 1:320, and 1:1000, respectively.

RESULTS

Comparison of the observation and the control groups without ANA subgrouping showed that the live birth rate in the observation group was higher (odds ratio 3.312, p < 0.001), and the miscarriage rate was lower than that of the control group (odds ratio 0.302, p < 0.001). Statistically significant results were obtained in ANA titer 1:100 subgrouping (p < 0.001). There was no significant difference between the observation groups and the control groups for the ANA titers 1:320 and 1:1000. No statistically significant differences were observed in pregnancy rate, birthweight, neonatal 1-min Apgar score, and incidence of pregnancy complications between the observation and the control groups. Besides, the treatment showed a low incidence of adverse effects.

CONCLUSION

In summary, RSA patients who are ANA positive (titer 1:100) but not yet diagnosed as AID can have improved pregnancy outcomes after treatment.