Steroid May Prevent Recurrent Miscarriages

A commonly used steroid medication may help women who suffer from frequent miscarriages.

A small new study shows that the steroid prednisolone reduces the amount of a type of cell linked to recurrent miscarriages. Researchers say that if further studies confirm these results, the findings may open up new avenues for treating and possibly preventing recurrent miscarriages.

"There are many unanswered questions at present, and we hope that randomized, controlled trials will shed more light on the mechanisms involved and whether the use of prednisolone may, in fact, represent a new and effective treatment for recurrent miscarriages," researcher Siobhan Quenby, senior lecturer and honorary consultant in the department of developmental and reproductive medicine at the University of Liverpool, says in a news release.

Quenby says her study is preliminary and she does not want women to be given false or premature hopes. "This is very exciting data, but the research is at a preliminary stage, so I cannot recommend it to patients without a proper trial. It is important that, in the excitement of new hope for these poor women for whom there is no treatment currently available, neither myself nor the media overexaggerate the results," Quenby says in the news release.

The study was presented this week at the annual conference of the European Society of Human Reproduction and Embryology in Copenhagen, Denmark.

Recurrent miscarriages, defined as three or more miscarriages, affect about two in every 100 women of reproductive age. There are no effective treatments available for the condition.

Prednisolone is a steroid that is commonly used to reduce inflammation caused by a variety of conditions, including asthma, skin conditions, and arthritis.

Read Web MD's "Understanding Miscarriage -- Treatment."

Read Web MD's "Multiple Miscarriages Linked to Gene."

Prednisolone May Prevent Miscarriages

Women with recurrent miscarriages have elevated levels of cells called uterine natural killer (uNK) cells. These infection-fighting white cells are found in high numbers in the uterus and the lining of the uterus that develops during pregnancy.

Recent studies have also shown that these uNK cells have steroid receptors on their surface.

In the study, researchers looked at whether giving women with recurrent miscarriages the steroid prednisolone could reduce the elevated uNK levels in their endometrium (uterine lining).

Researchers took endometrial samples from 110 women who had had an average of six miscarriages and tested them for uNK cells. Women with elevated uNK levels were then given the option to take 20 milligrams of prednisolone for 21 days from the start of their menstrual cycle.

The study showed that uNK levels dropped from an average of 14 percent before treatment to 9 percent in the 29 women with elevated uNK cells who took prednisolone.

"Although nine per cent is still higher than the normal average of five per cent, these women only took prednisolone for three weeks. In practice, they would have to take the steroid for longer before conception occurred, probably for about three months," says Quenby.

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By Jennifer Warner, reviewed by Brunilda Nazario, MD

SOURCES: 21st annual conference of the European Society of Human Reproduction and Embryology, Copenhagen, Denmark, June 19-22, 2005. News release, European Society of Human Reproduction and Embryology.