{"id":76,"title":"Pregnancy loss burden as a potential effect modifier of intravenous immunoglobulin effect on live birth in recurrent pregnancy loss: A secondary individual patient data meta-analysis","title_zh":"既往流产负担可能修饰静脉免疫球蛋白对复发性流产活产的影响：一项个体患者数据二次meta分析","url":"https://pubmed.ncbi.nlm.nih.gov/42981894","doi":"10.1016/j.jri.2026.104983","pmid":"42981894","journal":"J Reprod Immunol","kind":"paper","lang":"en","published_at":"2026-11-03T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Kofod L","Waagepetersen R","Christiansen OB","Kesmodel US"],"primary_topic":"early-pregnancy","topics":[{"slug":"early-pregnancy","score":7.0,"hits":["pregnancy loss","recurrent pregnancy loss"]},{"slug":"repro-immunology","score":5.0,"hits":["intravenous immunoglobulin","ivig"]},{"slug":"art-clinical","score":4.0,"hits":["live birth"]},{"slug":"repro-aging","score":1.0,"hits":["maternal age"]}],"topic_score":7.0,"preference_score":0.0,"preference_labels":[],"llm_score":78.0,"final_score":78.0,"score_dims":{"novelty":75,"rigor":78,"impact":72,"relevance":92,"translation":70},"recommend_reason":"基于6项RCT的个体患者数据二次分析，提出既往流产负担可作为IVIG疗效的潜在效应修饰因素，对复发性流产临床分层有启发；但结果为探索性，交互效应置信区间较宽，不宜直接改变实践。","keywords":["复发性流产","静脉免疫球蛋白","个体患者数据meta分析","活产","效应修饰"],"selected":1,"story_id":166,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究为个体患者数据二次meta分析，纳入6项随机试验，评估复发性流产患者既往流产次数是否修饰静脉免疫球蛋白（IVIG）对活产的影响。采用一阶段logistic回归，模型包含治疗、既往流产数、交互项、母亲年龄及研究截距。结果显示，安慰剂组每增加一次流产，活产OR约0.6；IVIG组约0.9，比值比之比1.50（95%CI 1.06–2.18）。提示IVIG对活产的效应可能随既往流产负担增加而增强，但属探索性发现，需谨慎解读。","summary":"Evidence for intravenous immunoglobulin (IVIG) in recurrent pregnancy loss remains inconsistent. This individual patient data meta-analysis aimed to explore possible treatment-effect modification by the number of previous pregnancy losses across six randomized trials. One-stage logistic regression included treatment, number of previous losses, their interaction, maternal age, and study-specific intercepts. The estimated live birth odds ratio for each additional loss was 0.6 in the placebo group and significantly higher 0.9 in the IVIG group (ratio of odds ratios 1.50, 95% CI 1.06-2.18). These exploratory findings suggest that the effect of IVIG on live birth odds may increase with previous loss burden.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}