Effects of Hydroxychloroquine Sulphate Combined with Aspirin and Enoxaparin Sodium Therapy on Perinatal Outcomes in Patients with Undifferentiated Connective Tissue Disease-related Recurrent Miscarriage: A Rretrospective Clinical Study

Background To investigate the effect of hydroxychloroquine sulphate combined with aspirin and enoxaparin sodium in treating recurrent miscarriage (RM) associated with undifferentiated connective tissue disease. Methods Pregnant women with RM admitted to Wuhai Maternal and Child Health Hospital between January 2021 and August 2024 were enrolled and assigned to groups based on different treatment regimens: control Group 1 (progesterone + enoxaparin sodium, n = 45), control Group 2 (aspirin + enoxaparin sodium, n = 45), and the exposed group (hydroxychloroquine sulphate + aspirin + enoxaparin sodium, n = 45). Pregnancy complications, pregnancy outcomes, delivery and neonatal status, serological indicators, imaging parameters, and adverse reactions were compared among the three groups. Data were statistically analysed using SPSS 26.0. Independent/paired t -test and one-way analysis of variance were conducted, with F -tests performed according to statistical requirements. Results (1) Baseline Characteristics : Patients in the exposed group were older and had an earlier gestational age at the last pregnancy termination ( P  < 0.05). No significant differences were observed in body mass index, gravidity, parity, or number of miscarriages among the groups ( P  > 0.05). (2) Pregnancy Complications : The overall incidence of pregnancy complications showed no significant difference between the exposed group and Control groups 1 and 2 ( P  > 0.05), indicating that the experimental regimen did not cause additional pregnancy complications. (3) Pregnancy and Neonatal Outcomes : The exposed group had significantly higher rates of preterm and term delivery (95.56%) than did the control groups 1 (80.0%) and 2 (77.78%) ( P  < 0.05). Cesarean section rates showed no significant difference among groups ( P  > 0.05). Apgar scores showed no significant difference between the exposed and control groups ( P  > 0.05). (4) Laboratory and imaging parameters : The 2-week post-treatment/pre-treatment ratio of human chorionic gonadotropin, estradiol, and progesterone did not differ significantly ( P  > 0.05). Yolk sac size, gestational sac-foetal pole difference, and uterine artery blood flow did not differ significantly between the exposed group and Control groups 1 and 2 ( P  > 0.05). Notably, the exposed group had the smallest gestational sac-foetal pole difference among the groups ( P  < 0.05), suggesting improved embryonic developmental potential. (5) Adverse Reactions : The exposed group showed no additional adverse reactions compared with Control groups 1 and 2, with no increased incidence of gastrointestinal reactions, liver dysfunction, bleeding tendency, rash, thrombocytopenia, or blurred vision ( P  > 0.05). Conclusion Combining hydroxychloroquine sulphate, aspirin, and enoxaparin sodium for treating RM associated with undifferentiated connective tissue disease improves pregnancy outcomes and demonstrates a favorable safety profile, with no observed additional adverse reactions.