{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:41:49Z","timestamp":1781689309332,"version":"3.54.5"},"reference-count":76,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,4,30]],"date-time":"2018-04-30T00:00:00Z","timestamp":1525046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>A comprehensive network meta\u2010analysis was designed to clarify contradictions and offer valuable clinical guidance in the treatment of recurrent spontaneous abortion (<jats:styled-content style=\"fixed-case\">RSA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The included clinical trials were selected from the relevant medical journal databases and screened. Treatments were ranked by the surface under the cumulative ranking curve. Heat plots were constructed to analyze the inconsistency between direct data and network results, and adjusted funnel plots were constructed to assess publication bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010nine randomized controlled trials involving a total of 8496 <jats:styled-content style=\"fixed-case\">RSA<\/jats:styled-content> patients were selected. With placebo as control, corticosteroid plus low dose aspirin (<jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content>) plus unfractionated heparin (<jats:styled-content style=\"fixed-case\">UFH<\/jats:styled-content>), granulocyte colony\u2010stimulating factor (G\u2010<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) alone, and <jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content> plus low molecular weight heparin (<jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content>) all demonstrated effectiveness in increasing successful live birth rates and reducing the incidences of miscarriage. However, no treatment was demonstrably superior to placebo in terms of pregnancy success. For all 3 endpoints (live birth, abortion and success pregnancy), the adjusted funnel plots were symmetric to zero and indicated no publication bias. In terms of live birth and abortion rates, no treatment outperformed placebo in patients with antiphospholipid syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In consideration of live birth and abortion rates, corticosteroid plus <jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">UFH<\/jats:styled-content> appeared to be the optimum treatment strategy; G\u2010<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> was second, followed by <jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> LDA<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content> plus intravenous immunoglobulin, corticosteroid with <jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content> and others. Subgroup analysis demonstrated no benefit of antithrombotic therapy in patients with antiphospholipid syndrome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.12856","type":"journal-article","created":{"date-parts":[[2018,4,30]],"date-time":"2018-04-30T17:54:15Z","timestamp":1525110855000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A comparison of effectiveness among frequent treatments of recurrent spontaneous abortion: A Bayesian network meta\u2010analysis"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8515-6877","authenticated-orcid":false,"given":"Sha","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics The Affiliated Hospital of Guizhou Medical University  Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging The Affiliated Hospital of Guizhou Medical University  Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics The Affiliated Hospital of Guizhou Medical University  Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,30]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"76","article-title":"Recurrent pregnancy loss: etiology, diagnosis, and therapy","volume":"2","author":"Ford HB","year":"2009","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/8.4.333"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/S0015-0282(16)58382-4","article-title":"Frequency of factors associated with habitual abortion in 197 couples","volume":"66","author":"Stephenson MD","year":"1996","journal-title":"Fertil Steril"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcibr1207279"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmr024"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmr005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.3.612"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.1.18"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198812223192501"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/154099904322836438"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-931797"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199409000-00023"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70610-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.theriogenology.2004.02.005"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.2.8207"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/7.2.161"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/6.6.614"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(99)00143-0"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902043400501"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(80)90061-6"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0340"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)58565-3"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1995.05040233.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001732"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2004.01.001"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.12.068"},{"key":"e_1_2_7_28_1","first-page":"1269","article-title":"A method of estimating comparative rates from clinical data; applications to cancer of the lung, breast, and cervix","volume":"11","author":"Cornfield J","year":"1951","journal-title":"J Natl Cancer Inst"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-015-0060-8"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-35"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-2055-y"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610802042688"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.12.033"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0897.2001.d01-12.x"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/12.2.250"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.1991.tb01057.x"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13192"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349409023451"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a135769"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.3.809"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-01-267252"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504927"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.1994.tb01127.x"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.1995.tb00960.x"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.06.026"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1994.tb13584.x"},{"key":"e_1_2_7_47_1","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1097\/00006250-200212000-00032","article-title":"Antiphospholipid syndrome in pregnancy: a randomized, controlled trial of treatment.[Erratum appears","volume":"100","author":"Farquharson RG","year":"2002","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-007-0527-x"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.09.010"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.600366"},{"key":"e_1_2_7_51_1","first-page":"CR132","article-title":"The role of Aspirin versus Aspirin and Heparin in cases of recurrent abortions with raised anticardiolipin antibodies","volume":"12","author":"Goel N","year":"2006","journal-title":"Med Sci Monit"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3262-0"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.09.004"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.3.838"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000641"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.07.1251"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199707173370302"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2016.1203408"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3922-8"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dev329"},{"issue":"1","key":"e_1_2_7_61_1","first-page":"S17","article-title":"Comparison of the effect of aspirin and heparin with or without intravenous immunoglobulin in treatment of recurrent abortion with unknown etiology: a clinical study","volume":"6","author":"Nazari Z","year":"2015","journal-title":"J Nat Sci Biol Med"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)12055-X"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-11-610857"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.106754"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/12.11.2388"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7076.253"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep240"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2062"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029616665167"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.1998.tb00339.x"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq179"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10957"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/12.7.1567"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH10-05-0334"},{"key":"e_1_2_7_75_1","first-page":"147","article-title":"The effect of progesterone suppositories on threatened abortion: a randomized clinical trial","volume":"15","author":"Yassaee F","year":"2014","journal-title":"J Reprod Infertil"},{"key":"e_1_2_7_76_1","first-page":"548","article-title":"Evaluation of the efficacy of aspirin and low molecular weight heparin in patients with unexplained recurrent spontaneous abortions","volume":"12","author":"Zolghadri J","year":"2010","journal-title":"Iran Red Crescent Med J"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH09-02-0091"}],"container-title":["American Journal of Reproductive Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faji.12856","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.12856","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T04:20:48Z","timestamp":1695442848000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aji.12856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,30]]},"references-count":76,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1111\/aji.12856"],"URL":"https:\/\/doi.org\/10.1111\/aji.12856","archive":["Portico"],"relation":{},"ISSN":["1046-7408","1600-0897"],"issn-type":[{"value":"1046-7408","type":"print"},{"value":"1600-0897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,30]]},"assertion":[{"value":"2017-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12856"}}