{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T04:55:41Z","timestamp":1787374541860,"version":"build-2736575974"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The etiology of recurrent pregnancy loss (RPL) is complex and multifactorial and in half of patients it remains unexplained (U-RPL). Recently, low-molecular-weight heparin (LMWH) has gained increasing relevance for its therapeutic potential. On this regard, the aim of this systematic review and meta-analysis is to analyze the efficacy of low molecular weight heparin (LMWH) from the beginning of pregnancy in terms of live birth rates (LBR) in U-RPL. Registered randomized controlled trials (RCTs) were included. We stratified findings based on relevant clinical factors including number of previous miscarriages, treatment type and control type. Intervention or exposure was defined as the administration of LMWH alone or in combination with low-dose aspirin (LDA). A total of 6 studies involving 1016 patients were included. The meta-analysis results showed that LMWH used in the treatment of U-RPL was not associated with an increase in LBR with a pooled OR of 1.01, a medium heterogeneity (26.42%) and no publication bias. Results of other sub-analyses according to country, treatment type, and control type showed no significant effect of LMWH on LBR in all subgroups, with a high heterogeneity. The results highlight a non-significant effect of LMWH in U-RPL on LBR based on moderate quality evidence.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Registration number:<\/jats:bold>\n                    PROSPERO: (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42022326433\">https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42022326433<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1038\/s41598-024-62949-5","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T11:01:59Z","timestamp":1718794919000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Low-molecular-weight heparin in the prevention of unexplained recurrent miscarriage: a systematic review and meta-analysis"],"prefix":"10.1038","volume":"14","author":[{"given":"Margherita","family":"Scarrone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Salmeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Buzzaccarini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Canti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Papaleo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Rovere-Querini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Candiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Alteri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Busnelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6539-7294","authenticated-orcid":false,"given":"Valeria Stella","family":"Vanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"62949_CR1","unstructured":"Recurrent Miscarriage, Investigation and Treatment of Couples (Green-Top Guideline No. 17) [WWW Document]. https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg17\/ (Accessed 3 August 2023) (Royal College of Obstetricians & Gynaecologists, n.d.)."},{"key":"62949_CR2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.fertnstert.2012.09.023","volume":"99","author":"Practice Committee of the American Society for Reproductive Medicine","year":"2013","unstructured":"Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: A committee opinion. Fertil. Steril. 99, 63. https:\/\/doi.org\/10.1016\/j.fertnstert.2012.09.023 (2013).","journal-title":"Fertil. Steril."},{"key":"62949_CR3","doi-asserted-by":"publisher","first-page":"004","DOI":"10.1093\/hropen\/hoy004","volume":"2018","author":"R Bender Atik","year":"2018","unstructured":"The ESHRE Guideline Group on RPL et al. ESHRE guideline: Recurrent pregnancy loss. Hum. Reprod. Open 2018, 004 (2018).","journal-title":"Hum. Reprod. Open"},{"issue":"3","key":"62949_CR4","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.fertnstert.2019.11.025","volume":"113","author":"Practice Committee of the American Society for Reproductive Medicine","year":"2020","unstructured":"Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: A committee opinion. Fertil. Steril. 113(3), 533\u2013535. https:\/\/doi.org\/10.1016\/j.fertnstert.2019.11.025 (2020).","journal-title":"Fertil. Steril."},{"issue":"1","key":"62949_CR5","doi-asserted-by":"publisher","first-page":"002","DOI":"10.1093\/hropen\/hoad002","volume":"2023","author":"R Bender Atik","year":"2023","unstructured":"Bender Atik, R. et al. ESHRE guideline: Recurrent pregnancy loss: An update in 2022. Hum. Reprod. Open 2023(1), 002. https:\/\/doi.org\/10.1093\/hropen\/hoad002 (2023).","journal-title":"Hum. Reprod. Open"},{"key":"62949_CR6","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/s0020-7292(02)00197-2","volume":"78","author":"American College of Obstetricians and Gynecologists","year":"2002","unstructured":"American College of Obstetricians and Gynecologists. ACOG practice bulletin. Management of recurrent pregnancy loss. Number 24, February 2001. (Replaces Technical Bulletin Number 212, September 1995). American College of Obstetricians and Gynecologists. Int. J. Gynaecol. Obstet. 78, 179\u2013190. https:\/\/doi.org\/10.1016\/s0020-7292(02)00197-2 (2002).","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"62949_CR7","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1016\/0140-6736(90)92159-f","volume":"336","author":"GM Stirrat","year":"1990","unstructured":"Stirrat, G. M. Recurrent miscarriage. Lancet 336, 673\u2013675. https:\/\/doi.org\/10.1016\/0140-6736(90)92159-f (1990).","journal-title":"Lancet"},{"issue":"18","key":"62949_CR8","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1056\/NEJMcp1005330","volume":"363","author":"DW Branch","year":"2010","unstructured":"Branch, D. W., Gibson, M. & Silver, R. M. Clinical practice. Recurrent miscarriage. N. Engl. J. Med. 363(18), 1740\u20131747. https:\/\/doi.org\/10.1056\/NEJMcp1005330 (2010).","journal-title":"N. Engl. J. Med."},{"issue":"9535","key":"62949_CR9","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/S0140-6736(06)69204-0","volume":"368","author":"R Rai","year":"2006","unstructured":"Rai, R. & Regan, L. Recurrent miscarriage. Lancet 368(9535), 601\u2013611. https:\/\/doi.org\/10.1016\/S0140-6736(06)69204-0 (2006).","journal-title":"Lancet"},{"issue":"2","key":"62949_CR10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.ajog.2019.12.006","volume":"223","author":"A Coomarasamy","year":"2020","unstructured":"Coomarasamy, A. et al. Micronized vaginal progesterone to prevent miscarriage: A critical evaluation of randomized evidence. Am. J. Obstet. Gynecol. 223(2), 167\u2013176. https:\/\/doi.org\/10.1016\/j.ajog.2019.12.006 (2020).","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"10285","key":"62949_CR11","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1016\/S0140-6736(21)00681-4","volume":"397","author":"A Coomarasamy","year":"2021","unstructured":"Coomarasamy, A. et al. Recurrent miscarriage: Evidence to accelerate action. Lancet. 397(10285), 1675\u20131682. https:\/\/doi.org\/10.1016\/S0140-6736(21)00681-4 (2021).","journal-title":"Lancet."},{"key":"62949_CR12","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ejogrb.2023.01.002","volume":"282","author":"L Linehan","year":"2023","unstructured":"Linehan, L., Hennessy, M. & O\u2019Donoghue, K. An examination of care received by women with recurrent miscarriage and infertility against guideline-based key performance indicators. Eur. J. Obstet. Gynecol. Reprod. Biol. 282, 17\u201323. https:\/\/doi.org\/10.1016\/j.ejogrb.2023.01.002 (2023).","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"issue":"2","key":"62949_CR13","doi-asserted-by":"publisher","first-page":"S1145","DOI":"10.1016\/j.ajog.2021.08.027","volume":"226","author":"K McLaughlin","year":"2022","unstructured":"McLaughlin, K. et al. Circulating maternal placental growth factor responses to low-molecular-weight heparin in pregnant patients at risk of placental dysfunction. Am. J. Obstetr. Gynecol. 226(2), S1145\u2013S1156. https:\/\/doi.org\/10.1016\/j.ajog.2021.08.027 (2022).","journal-title":"Am. J. Obstetr. Gynecol."},{"key":"62949_CR14","doi-asserted-by":"publisher","first-page":"e691","DOI":"10.7717\/peerj.691","volume":"3","author":"M Quaranta","year":"2015","unstructured":"Quaranta, M. et al. The physiologic and therapeutic role of heparin in implantation and placentation. PeerJ 3, e691. https:\/\/doi.org\/10.7717\/peerj.691 (2015).","journal-title":"PeerJ"},{"key":"62949_CR15","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.phrs.2016.08.008","volume":"123","author":"AA Manfredi","year":"2017","unstructured":"Manfredi, A. A., Rovere-Querini, P., D\u2019Angelo, A. & Maugeri, N. Low molecular weight heparins prevent the induction of autophagy of activated neutrophils and the formation of neutrophil extracellular traps. Pharmacol. Res. 123, 146\u2013156. https:\/\/doi.org\/10.1016\/j.phrs.2016.08.008 (2017).","journal-title":"Pharmacol. Res."},{"key":"62949_CR16","doi-asserted-by":"publisher","first-page":"4780","DOI":"10.1182\/blood-2011-07-319749","volume":"118","author":"JCP Kingdom","year":"2011","unstructured":"Kingdom, J. C. P. & Drewlo, S. Is heparin a placental anticoagulant in high-risk pregnancies? Blood 118, 4780\u201388. https:\/\/doi.org\/10.1182\/blood-2011-07-319749 (2011).","journal-title":"Blood"},{"issue":"4","key":"62949_CR17","doi-asserted-by":"publisher","first-page":"2644","DOI":"10.1074\/jbc.M110176200","volume":"277","author":"J Guerin","year":"2002","unstructured":"Guerin, J. et al. Heparin inhibits the binding of beta 2-glycoprotein I to phospholipids and promotes the plasmin-mediated inactivation of this blood protein. Elucidation of the consequences of the two biological events in patients with the anti-phospholipid syndrome. J. Biol. Chem. 277(4), 2644\u20132649. https:\/\/doi.org\/10.1074\/jbc.M110176200 (2002).","journal-title":"J. Biol. Chem."},{"key":"62949_CR18","doi-asserted-by":"publisher","first-page":"2200","DOI":"10.1182\/blood-2014-11-610857","volume":"125","author":"E Pasquier","year":"2015","unstructured":"Pasquier, E. et al. Enoxaparin for prevention of unexplained recurrent miscarriage: A multicenter randomized double-blind placebo-controlled trial. Blood 125, 2200\u20132205. https:\/\/doi.org\/10.1182\/blood-2014-11-610857 (2015).","journal-title":"Blood"},{"key":"62949_CR19","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004734.pub4","author":"PG de Jong","year":"2014","unstructured":"de Jong, P. G., Kaandorp, S., Di Nisio, M., Goddijn, M. & Middeldorp, S. Aspirin and\/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia. Cochrane Database Syst. Rev. https:\/\/doi.org\/10.1002\/14651858.CD004734.pub4 (2014).","journal-title":"Cochrane Database Syst. Rev."},{"key":"62949_CR20","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.fertnstert.2005.12.068","volume":"86","author":"M Dolitzky","year":"2006","unstructured":"Dolitzky, M. et al. A randomized study of thromboprophylaxis in women with unexplained consecutive recurrent miscarriages. Fertil. Steril. 86, 362\u2013366. https:\/\/doi.org\/10.1016\/j.fertnstert.2005.12.068 (2006).","journal-title":"Fertil. Steril."},{"issue":"2S","key":"62949_CR21","doi-asserted-by":"publisher","first-page":"S1126","DOI":"10.1016\/j.ajog.2020.11.006","volume":"226","author":"M Cruz-Lemini","year":"2022","unstructured":"Cruz-Lemini, M., V\u00e1zquez, J. C., Ullmo, J. & Llurba, E. Low-molecular-weight heparin for prevention of preeclampsia and other placenta-mediated complications: A systematic review and meta-analysis. Am. J. Obstet. Gynecol. 226(2S), S1126\u2013S1144. https:\/\/doi.org\/10.1016\/j.ajog.2020.11.006 (2022).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"62949_CR22","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1056\/NEJMoa1000641","volume":"362","author":"SP Kaandorp","year":"2010","unstructured":"Kaandorp, S. P. et al. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N. Engl. J. Med. 362, 1586\u20131596. https:\/\/doi.org\/10.1056\/NEJMoa1000641 (2010).","journal-title":"N. Engl. J. Med."},{"key":"62949_CR23","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.ejogrb.2018.12.023","volume":"234","author":"T Lin","year":"2019","unstructured":"Lin, T., Chen, Y., Cheng, X., Li, N. & Sheng, X. Enoxaparin (or plus aspirin) for the prevention of recurrent miscarriage: A meta-analysis of randomized controlled studies. Eur. J. Obstet. Gynecol. Reprod. Biol. 234, 53\u201357. https:\/\/doi.org\/10.1016\/j.ejogrb.2018.12.023 (2019).","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"62949_CR24","doi-asserted-by":"publisher","first-page":"1650","DOI":"10.1182\/blood-2015-12-626739","volume":"127","author":"L Skeith","year":"2016","unstructured":"Skeith, L. et al. A meta-analysis of low-molecular-weight heparin to prevent pregnancy loss in women with inherited thrombophilia. Blood 127, 1650\u20131655. https:\/\/doi.org\/10.1182\/blood-2015-12-626739 (2016).","journal-title":"Blood"},{"key":"62949_CR25","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/j.1538-7836.2004.01090.x","volume":"3","author":"B Brenner","year":"2005","unstructured":"Brenner, B. et al. Efficacy and safety of two doses of enoxaparin in women with thrombophilia and recurrent pregnancy loss: the LIVE-ENOX study. J. Thromb. Haemost. 3, 227\u2013229. https:\/\/doi.org\/10.1111\/j.1538-7836.2004.01090.x (2005).","journal-title":"J. Thromb. Haemost."},{"key":"62949_CR26","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1046\/j.1538-7836.2003.00066.x","volume":"1","author":"H Carp","year":"2003","unstructured":"Carp, H., Dolitzky, M. & Inbal, A. Thromboprophylaxis improves the live birth rate in women with consecutive recurrent miscarriages and hereditary thrombophilia. J. Thromb. Haemost. 1, 433\u2013438. https:\/\/doi.org\/10.1046\/j.1538-7836.2003.00066.x (2003).","journal-title":"J. Thromb. Haemost."},{"key":"62949_CR27","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s11845-017-1569-0","volume":"186","author":"C Karada\u011f","year":"2017","unstructured":"Karada\u011f, C. et al. Obstetric outcomes of recurrent pregnancy loss patients diagnosed w\u0131th inherited thrombophilia. Iran. J. Med. Sci. 186, 707\u2013713. https:\/\/doi.org\/10.1007\/s11845-017-1569-0 (2017).","journal-title":"Iran. J. Med. Sci."},{"key":"62949_CR28","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s12959-016-0118-9","volume":"14","author":"M-C Shen","year":"2016","unstructured":"Shen, M.-C. et al. Low-molecular-weight-heparin can benefit women with recurrent pregnancy loss and sole protein S deficiency: A historical control cohort study from Taiwan. Thromb. J. 14, 44. https:\/\/doi.org\/10.1186\/s12959-016-0118-9 (2016).","journal-title":"Thromb. J."},{"key":"62949_CR29","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.ejogrb.2021.10.036","volume":"268","author":"X Yan","year":"2022","unstructured":"Yan, X., Wang, D., Yan, P. & Li, H. Low molecular weight heparin or LMWH plus aspirin in the treatment of unexplained recurrent miscarriage with negative antiphospholipid antibodies: A meta-analysis of randomized controlled trial. Eur. J. Obstet. Gynecol. Reprod. Biol. 268, 22\u201330. https:\/\/doi.org\/10.1016\/j.ejogrb.2021.10.036 (2022).","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"62949_CR30","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.3109\/14767058.2011.600366","volume":"25","author":"A Giancotti","year":"2012","unstructured":"Giancotti, A. et al. Efficacy of three different antithrombotic regimens on pregnancy outcome in pregnant women affected by recurrent pregnancy loss. J. Matern. Fetal Neonatal Med. 25, 1191\u20131194. https:\/\/doi.org\/10.3109\/14767058.2011.600366 (2012).","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"62949_CR31","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1160\/TH10-05-0334","volume":"105","author":"J Visser","year":"2011","unstructured":"Visser, J. et al. Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia: HABENOX: A randomised multicentre trial. Thromb. Haemost. 105, 295\u2013301. https:\/\/doi.org\/10.1160\/TH10-05-0334 (2011).","journal-title":"Thromb. Haemost."},{"key":"62949_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14767058.2021.1957819","volume":"1","author":"G Wang","year":"2021","unstructured":"Wang, G., Zhang, R., Li, C. & Chen, A. Evaluation of the effect of low molecular weight heparin in unexplained recurrent pregnancy loss: A meta-analysis of randomized controlled trials. J. Matern. Fetal Neonatal Med. 1, 1\u20138. https:\/\/doi.org\/10.1080\/14767058.2021.1957819 (2021).","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"62949_CR33","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1080\/01443610802042688","volume":"28","author":"AM Badawy","year":"2008","unstructured":"Badawy, A. M. et al. Low-molecular weight heparin in patients with recurrent early miscarriages of unknown aetiology. J. Obstetr. Gynaecol. 28, 280\u2013284. https:\/\/doi.org\/10.1080\/01443610802042688 (2008).","journal-title":"J. Obstetr. Gynaecol."},{"key":"62949_CR34","unstructured":"Deeks, J. J., Higgins, J. P. T. & Altman, D. G. Chapter 10: Analysing data and undertaking meta-analyses. In Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (Updated February 2022) (eds. Higgins, J. P. T. et al.). https:\/\/training.cochrane.org\/handbook\/current\/chapter-10#section-10-11-2 (2022)."},{"key":"62949_CR35","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1016\/j.jclinepi.2009.06.005","volume":"62","author":"D Moher","year":"2009","unstructured":"Moher, D. et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. J. Clin. Epidemiol. 62, 1006\u20131012 (2009).","journal-title":"J. Clin. Epidemiol."},{"issue":"15","key":"62949_CR36","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","volume":"283","author":"DF Stroup","year":"2000","unstructured":"Stroup, D. F. et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. JAMA 283(15), 2008\u20132012. https:\/\/doi.org\/10.1001\/jama.283.15.2008 (2000).","journal-title":"JAMA"},{"key":"62949_CR37","doi-asserted-by":"publisher","unstructured":"Mol, B. W. et al. A Checklist to Assess Trustworthiness in Randomised Controlled Trials (TRACT Checklist), PREPRINT (Version 1). https:\/\/doi.org\/10.21203\/rs.3.rs-2119486\/v1 (2023).","DOI":"10.21203\/rs.3.rs-2119486\/v1"},{"key":"62949_CR38","volume-title":"The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomized Studies in Meta-analyses","author":"GA Wells","year":"2009","unstructured":"Wells, G. A., Shea, B. & O\u2019Connell, D. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomized Studies in Meta-analyses (The Ottawa Health Research Institute, 2009)."},{"key":"62949_CR39","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","volume":"366","author":"JAC Sterne","year":"2019","unstructured":"Sterne, J. A. C. et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ 366, l4898. https:\/\/doi.org\/10.1136\/bmj.l4898 (2019).","journal-title":"BMJ"},{"key":"62949_CR40","first-page":"149","volume":"328","author":"D Atkins","year":"2004","unstructured":"Atkins, D. et al. Grading quality of evidence and strength of recommendations. BMJ 328, 149 (2004).","journal-title":"BMJ"},{"key":"62949_CR41","doi-asserted-by":"publisher","first-page":"17","DOI":"10.7196\/SAJOG.2017.v23i1.1112","volume":"23","author":"ES Khan","year":"2017","unstructured":"Khan, E. S., Basharat, A., Jamil, M., Ayub, S. & Khan, M. A. Preventive role of low-molecular-weight heparin in unexplained recurrent pregnancy loss. S. Afr. J. Obstetr. Gynaecol. 23, 17. https:\/\/doi.org\/10.7196\/SAJOG.2017.v23i1.1112 (2017).","journal-title":"S. Afr. J. Obstetr. Gynaecol."},{"key":"62949_CR42","doi-asserted-by":"publisher","first-page":"78","DOI":"10.4103\/jrms.jrms_81_21","volume":"27","author":"A Mohammad-Akbari","year":"2022","unstructured":"Mohammad-Akbari, A. et al. The effect of low-molecular-weight heparin on live birth rate of patients with unexplained early recurrent pregnancy loss: A two-arm randomized clinical trial. J. Res. Med. Sci. 27, 78. https:\/\/doi.org\/10.4103\/jrms.jrms_81_21 (2022).","journal-title":"J. Res. Med. Sci."},{"key":"62949_CR43","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1093\/humrep\/deab15","volume":"36","author":"E Grandone","year":"2021","unstructured":"Grandone, E. et al. Findings from a multicentre, observational study on reproductive outcomes in women with unexplained recurrent pregnancy loss: The OTTILIA registry. Hum. Reprod. 36, 2083\u20132090. https:\/\/doi.org\/10.1093\/humrep\/deab15 (2021).","journal-title":"Hum. Reprod."},{"key":"62949_CR44","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/S0015-0282(99)00495-1","volume":"73","author":"M Ogasawara","year":"2000","unstructured":"Ogasawara, M., Aoki, K., Okada, S. & Suzumori, K. Embryonic karyotype of abortuses in relation to the number of previous miscarriages. Fertil. Steril. 73, 300\u2013304. https:\/\/doi.org\/10.1016\/S0015-0282(99)00495-1 (2000).","journal-title":"Fertil. Steril."},{"key":"62949_CR45","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.ejogrb.2021.03.001","volume":"260","author":"M Scarrone","year":"2021","unstructured":"Scarrone, M. et al. Low-molecular-weight heparin for prevention of unexplained recurrent miscarriage. Eur. J. Obstet. Gynecol. Reprod. Biol. 260, 235\u2013236. https:\/\/doi.org\/10.1016\/j.ejogrb.2021.03.001 (2021).","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-62949-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-62949-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-62949-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T15:03:48Z","timestamp":1719068628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-62949-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["62949"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-62949-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,19]]},"assertion":[{"value":"2 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This article received no funding. E.P. reports grant and personal fees from MSD, grants from Ferring, from IBSA, grants and personal fees from Merck, grants from TEVA, grants from Gedeon Richter, not related to the present study. VSV reports consultancies with IBSA and Gedeon Richter, not related to the present study. All the other authors have no conflicts of interest to declare in this manuscript preparation.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14168"}}