{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T16:55:54Z","timestamp":1775840154282,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Anti-\u03b22-glycoprotein I (\u03b22GPI)\/human leukocyte antigen (HLA)-DR antibodies may be a risk factor for recurrent pregnancy loss (RPL). The therapeutic modality for women with RPL and anti-\u03b22GPI\/HLA-DR antibody positivity has not been evaluated. This prospective, multicenter, observational study aimed to assess whether low-dose aspirin (LDA) and\/or heparin therapies improve pregnancy outcomes in women with RPL who tested positive for anti-\u03b22GPI\/HLA-DR antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between August 2019 and December 2021, 462 women with RPL underwent anti-\u03b22GPI\/HLA-DR antibody measurements and risk assessments for RPL. Each attending physician decided the treatment modality for women with RPL who tested positive for anti-\u03b22GPI\/HLA-DR antibodies, and their pregnancy outcomes were followed up until December 2023. Finally, 47 pregnancies in 47 women with RPL and anti-\u03b22GPI\/HLA-DR antibody positivity were included in the analysis and were divided into two groups regarding whether they were treated with LDA and\/or unfractionated heparin (UFH) (LDA\/UFH group, n = 39) or with neither of them (non-LDA\/non-UFH group, n = 8). The rates of live birth and pregnancy complications (i.e., preeclampsia and preterm delivery before 34 gestational weeks due to placental insufficiency) were compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The live birth rate in the LDA\/UFH group was higher than that in the non-LDA\/non-UFH group (87.2% vs 50.0%, <jats:italic>p<\/jats:italic> = 0.03). The pregnancy complication rate in the LDA\/UFH group was significantly lower than that in the non-LDA\/non-UFH group (5.9% vs 50.0%, <jats:italic>p<\/jats:italic> = 0.048). Among 21 women who tested positive for anti-\u03b22GPI\/HLA-DR antibodies and had no other risk factors for RPL, the live birth rate in the LDA\/UFH group (n = 14) was much higher than that in the non-LDA\/non-UFH group (n = 7) (92.9% vs 42.9%, <jats:italic>p<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study, for the first time, demonstrated that LDA and\/or UFH therapies are effective in improving pregnancy outcomes in women with RPL and a\u03b22GPI\/HLA-DR antibody positivity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1445852","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T04:25:20Z","timestamp":1727324720000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Low-dose aspirin and heparin treatment improves pregnancy outcome in recurrent pregnancy loss women with anti-\u03b22-glycoprotein I\/HLA-DR 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