Comparative trial of prednisone plus aspirin versus aspirin alone in the treatment of anticardiolipin antibody-positive obstetric patients

Richard K. Silver*, Scott N. MacGregor, John S. Sholl, John M. Hobart, Mark G. Neerhof, Ann B Ragin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

236 Scopus citations

Abstract

OBJECTIVE: We compared the use of aspirin alone with combined therapy (prednisone plus aspirin) in antiphospholipid antibody-positive obstetric patients with prior adverse pregnancy outcome. STUDY DESIGN: Thirty-nine patients meeting specific laboratory and clinical inclusion criteria were randomized to receive either combined therapy (prednisone plus low-dose aspirin, (n = 17) or aspirin alone (n = 22). The daily aspirin dose was 81 mg; prednisone was begun at 20 mg/day and increased or decreased on the basis of observed changes in serial antibody levels. Perinatal outcomes were compared between groups. Evaluation of treatment-related maternal complications and serial antibody titers was also accomplished. RESULTS: Thirty-four randomized subjects were evaluable (prednisone plus low-dose aspirin, n = 12 vs aspirin only, n = 22); no perinatal losses were observed in the study cohort. Preterm delivery was experienced by significantly more patients receiving prednisone plus low-dose aspirin than aspirin only ( 8 12 vs 3 22, respectively; p = 0.003), and prednisone exposure appeared to be an independent risk factor for preterm birth. CONCLUSIONS: The use of prednisone therapy in conjunction with low-dose aspirin does not appear to improve outcome and may provoke obstetric complications in antiphospholipid antibody-positive patients.

Original languageEnglish (US)
Pages (from-to)1411-1417
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume169
Issue number6
DOIs
StatePublished - Jan 1 1993

Keywords

  • Antiphospholipid antibody
  • aspirin
  • prednisone
  • pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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