Glucocorticoids Improves Pregnancy Rate and Outcome in Woman With Unexplained Positive Autoantibody: a Systematic Review and Meta-analysis

Abstract Background: The effect of glucocorticoids (GCs) therapy for women with unexplained positive autoantibody is under debate. This systematic review and meta-analysis was performed to evaluate whether GCs administration can improve the pregnancy outcome of this population.Methods: A meta-analysis based on a systematic review of PubMed, Embase, EBSCO, and the Cochrane Central Register of Controlled Trials, until January 2021, was used to evaluate pregnancy outcome of GCs treatment for women with unexplained recurrent fetal loss or infertility whose autoantibody positive, but does not meet any classification criteria for autoimmune diseases.Results: We found GCs treatment improved clinical pregnancy rate (RR 2.19, 95% CI 1.64 to 2.92) and live birth rate (RR 1.92, 95% CI 1.17 to 3.16), especially when started GCs administration before pregnancy (clinical pregnancy rate: RR 2.30, 95% CI 1.58 to 3.34; live birth rate: RR 2.30, 95% CI 1.58 to 3.34). However, no effect of GCs on miscarriage rate was found (RR 0.75, 95% CI 0.55 to 1.02) regardless of time of drug administration.Conclusions: Our systematic review and meta-analysis surports the rational use of GCs in women with unexplained positive autoantibody.