Enoxaparin (or plus aspirin) for the prevention of recurrent miscarriage: A meta-analysis of randomized controlled studies

Enoxaparin treatment has emerged as an important approach to prevent recurrent miscarriage, but the use of enoxaparin for the prevention of recurrent miscarriage has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of enoxaparin to prevent recurrent miscarriage. PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of enoxaparin (or plus aspirin) treatment versus placebo on prevention of recurrent miscarriage are included. Three RCTs are included in the meta-analysis. Compared with control intervention for recurrent miscarriage, enoxaparin treatment has no substantial influence on live births (RR = 1.07; 95% CI = 0.77–1.47; P = 0.69), miscarriage rate (RR = 0.82; 95% CI = 0.31–2.17; P = 0.68), gestational age (Std. MD=−0.13; 95% CI=−0.78 to 0.52; P = 0.69), birth weight (Std. MD = 0.05; 95% CI=−0.41 to 0.51; P = 0.82), but leads to the increase in pre-eclampsia (RR = 3.42; 95% CI = 1.15–10.11; P = 0.03). Enoxaparin treatment has no additional benefits for women with recurrent miscarriage.