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首页> 外文期刊>The New England journal of medicine >Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss.
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Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss.

机译：患有自身抗体和无法解释的反复胎儿流产的女性使用泼尼松和阿司匹林。

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BACKGROUND: Recurrent fetal loss has been well described in women with antiphospholipid antibodies. Such women also often have other autoantibodies commonly found in patients with systemic lupus erythematosus. Treating them with prednisone and aspirin may reduce the risk of fetal loss. METHODS: We screened 773 nonpregnant women who had the unexplained loss of at least two fetuses for antinuclear, anti-DNA, antilymphocyte, and anticardiolipin antibodies and for the lupus anticoagulant. Of 385 women with at least one autoantibody, 202 who later became pregnant were randomly assigned in equal numbers to receive either prednisone (0.5 to 0.8 mg per kilogram of body weight per day) and aspirin (100 mg per day) or placebo for the duration of the pregnancy. The women were stratified according to age (18 to 34 years or 35 to 39 years) and the week of gestation at which the previous fetal losses had occurred (< or = 12 or > 12 weeks). The primary outcome measure was a successful pregnancy. RESULTS: Live infantswere born to 66 women in the treatment group (65 percent) and 57 women in the placebo group (56 percent, P=0.19). More infants were born prematurely in the treatment group than in the placebo group (62 percent vs. 12 percent, P<0.001). The major side effects of therapy in the mothers were hypertension (treatment group, 13 percent; placebo group, 5 percent; P=0.05) and diabetes mellitus (15 percent and 5 percent, P=0.02). CONCLUSIONS: Treating women who have autoantibodies and recurrent fetal loss with prednisone and aspirin is not effective in promoting live birth, and it increases the risk of prematurity.
机译：背景：在具有抗磷脂抗体的女性中，反复出现的胎儿流失已有很好的描述。这类女性通常还具有其他自身抗体，通常存在于系统性红斑狼疮患者中。用泼尼松和阿司匹林治疗可能会降低胎儿流产的风险。方法：我们筛选了773名未怀孕的妇女，这些妇女因抗核，抗DNA，抗淋巴细胞和抗心磷脂抗体以及狼疮抗凝剂的原因而损失了至少两个胎儿。在385名至少具有一种自身抗体的妇女中，有202名后来怀孕的妇女被随机分配为相等数量，以在该期间接受泼尼松（每天每公斤体重0.5至0.8 mg）和阿司匹林（每天100 mg）或安慰剂怀孕根据年龄（18至34岁或35至39岁）和先前发生胎儿流产的妊娠周（<或= 12或> 12周）对妇女进行分层。主要结局指标是妊娠成功。结果：治疗组中有66名妇女（65％）和安慰剂组中有57名妇女（56％，P = 0.19）。与安慰剂组相比，治疗组早产儿多（62％比12％，P <0.001）。母亲的主要治疗副作用是高血压（治疗组13％;安慰剂组5％; P = 0.05）和糖尿病（15％和5％，P = 0.02）。结论：用泼尼松和阿司匹林治疗患有自身抗体和反复胎儿流产的妇女并不能有效地促进活产，而且会增加早产的风险。

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