THE POTENTIAL ROLE OF LOW-DOSE PREDNISONE FOR THE THERAPY OF AUTOIMMUNE REPRODUCTIVE FAILURE
- Javier Carbone, Spain
Abstract
Background and Aims
Recurrent reproductive failure includes repeated pregnancy loss or implantation failure. The only accepted immunological abnormality of recurrent pregnancy loss in international guidelines is the presence of antiphospholipid antibodies. There are no well-accepted immunological factors of repeated implantation failure. However distinct studies have demonstrated the potential role of other autoantibodies mainly among women with recurrent pregnancy loss. In this study we preliminary evaluated the efficacy and safety of low-dose prednisone in a small number of women with autoimmune reproductive failure.
Methods
In this study we defined autoimmune reproductive failure as a previous history of primary recurrent pregnancy loss (more than 3 pregnancy losses) or recurrent implantation failure in the presence of antinuclear or anti-thyroid antibodies with or without C3 or C4 hypocomplementemia. None of the patients disclosed full-blown SLE. After informed consent the women were treated with low-dose prednisone (10 mg/day) from the day of a positive pregnancy test to week 12 of pregnancy. A prospective follow-up was performed to assess efficacy and safety.
Results
4 out of 12 women with autoimmune reproductive failure were treated with low-dose prednisone. During follow-up none of these patients developed severe infections, diabetes, arterial hypertension or pre-eclampsia. All women delivered healthy newborns with normal APGAR scores. None of the infants were born prematurely.
Conclusions
Treating women who had antinuclear antibodies and recurrent reproductive failure with low-dose prednisone during the first 3 months of pregnancy was effective in promoting live birth in a small serie of cases. The role of this immuneguided therapy warrants evaluation in a clinical trial.