Aspirin alone or in combination with nadroparin did not improve live birth rate in women with recurrent miscarriage

The use of aspirin alone or in combination with the low–molecular-weight heparin nadroparin did not improve the live birth rate among women with unexplained recurrent miscarriage, according to the results of the Anticoagulants for Living Fetuses, or ALIFE, study.

“It has been suggested that in women with recurrent miscarriage and a diagnosis of the antiphospholipid syndrome, treatment with aspirin and heparin may improve the pregnancy outcome, although findings from available randomized trials have been inconsistent,” researchers wrote in the study.

In this randomized trial, 364 women aged 18 to 42 years with a history of recurrent miscarriage were enrolled. Women were attempting to get pregnant or were less than six weeks pregnant. Patients were randomly assigned to 80 mg of aspirin daily plus subcutaneous nadroparin (n=123), 80 mg of aspirin alone (n=120) or placebo (n=121).

Of the women enrolled, 82.1% became pregnant. Live birth occurred in 54.1% of all patients enrolled and in 65.9% of women who became pregnant.

Of the 364 women enrolled, 54.5% of women in the combination group gave birth to a live infant compared with 50.8% in the aspirin-alone group and 57% in the placebo group. Rates of live birth among just those women who became pregnant were also similar between treatment groups: 69.1% in the combination group, 61.6% in the aspirin-alone group and 67% in the placebo group.

These results were originally presented at the 51st ASH Annual Meeting and Exposition.

Kaandorp SP. N Engl J Med. 2010;doi:10.1056/NEJMoa1000641.