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Abstract To investigate the influence of Low Molecular Weight Heparin (LMWH) combined with low dosage aspirin on pre-thrombotic state (PTS) and immune function of women with unexplained recurrent spontaneous abortion (URSA). Methods: 102 women with URSA in the first trimester of pregnancy from January 2016 to January 2017 were randomly divided into observation group and control group (51 cases in each group). The patients in control group were treated by low dosage aspirin, and the patients in observation group were treated by LMWH combined with low dosage aspirin. The pregnancy outcomes and adverse reactions of women were compared between the two groups. Another 51 normal pregnant women were included in health group. The PTS related indicators ［serum level of D-dimer (DD), antithrombin III (AT-III) activity, protein C (PC) activity, protein S (PS) activity, tissue plasminogen activator (t- PA), or plasminogen activator inhibitor-1 (PAI-1)］, immune function related indicators ［serum level ofinterleukin-17 (IL-17), interleukin-6 (IL-6), transforming growth factor- β(TGF-β), interleukin-10 (IL-10), γ-interferon (IFN-γ) and interleukin-4 (IL-4)］of all included women were measured before and after treatment. 51 healthy early pregnant women were collected as NC group, the above indicators were compared between the URSA group and NC group. Results: The levels of serum DD, t-PA, PAI-1, IL-17, IL-6 and IFN-γof women with URSA were significantly higher than those of women in health group, while levels of serum AT-III, PC, PS activity, TGF-β, IL-10,IL-4 of women were significant lower than those of women in health group (P<0.05). At 12 or 20 gestational weeks, compared with before treatment, the levels of serum DD, t-PA, PAI-1, IL-17, IL-6 and IFN-γ of women with URSA of pregnancy significantly decreased after treatment, but levels of serum AT-III, PC, PS activity, TGF-β IL-10,IL-4 significantly increased (P<0.05),and the levels of serum DD, PAI-1, IL-17, IL-6 and IFN-γ of women in observation group were significant lower than those of women in control group, and the levels of serum AT-III, PC, PS activity, TGF-β, IL-10,IL-4 of women were significant higher than those of women in control group (P<0.05).The success rate of tocolysis in observation group was 88.2%, which was significant higher than that (70.6%) in control group (P<0.05). There was no significant difference in the incidences of pregnant complication and adverse reaction between the two groups (P>0.05). Conclusion: LMWH combined with low dosage aspirin is safe and effective for treating women with URSA, which can improve the live birth rate without increasing the incidence of complications and adverse reactions. LMWH combined with low dosage aspirin may be related to the improvement of PTS and immune dysfunction.
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