APMAdvances in Precision Medicine2424-85922424-9106WHIOCE PUBLISHING PTE. LTD.10.18063/APM.v11i3.1663ArticleClinical Study on Low-Dose Aspirin Improving Pregnancy Outcomes in Unexplained Recurrent Spontaneous Abortion Based on Gut-Immune Axis Mechanismhttps://artdesignp.com/journal/APM/11/3/10.18063/APM.v11i3.1663YuanQing,WangKuo20261132026-03-26Objective: The study wanted to see if taking low-dose aspirin could help improve pregnancy outcomes for people with unexplained recurrent miscarriages. The study also looked into how it might work by affecting gut bacteria and the immune system. Methods: The study conducted a retrospective review of medical records from 71 pregnant women diagnosed with unexplained recurrent spontaneous abortion (URSA), defined as two or more consecutive pregnancy losses without an identifiable etiology. After excluding cases with incomplete outcome data, 68 patients were included in the final analysis. Baseline clinical data, including age, BMI, number of previous miscarriages, endocrine comorbidities, and concurrent medications, were systematically extracted. Based on real-world treatment regimens, the cohort was stratified into an Aspirin group (n = 6) and a Control group (n = 62). The primary clinical endpoints evaluated were ultimate pregnancy outcomes, specifically categorized as term delivery, preterm delivery, or recurrent miscarriage. Additionally, the study assessed the safety profile of low-dose aspirin by monitoring the incidence of adverse maternal bleeding events, such as estimated blood loss and postpartum hemorrhage. Results: The study looked back at 68 patients with URSA, real-world data. Their median age was 34, and they’d had a median of three miscarriages before. Now, the groups were pretty lopsided, only 6 got aspirin, versus 62 in the control group, but their starting points, their baseline stuff, were similar. Anyway, the clinical results were really encouraging. Like, the live birth rate for the aspirin group was 83.3%, which is remarkable, especially compared to just 45.2% in the controls. That’s a huge difference. The P-value was borderline, 0.089, which is probably because the aspirin group was so small. But still, it’s a strong trend, a protective one against more miscarriages. What I mean is, the signal is there. On safety, and this is important, aspirin looked excellent. Serious bleeding events were super rare, just isolated cases. One had a postpartum hemorrhage of around 600 to 650 ml, things like that. And there was no statistical difference from the control group. So, it seems aspirin doesn’t really bump up the bleeding risk for the mother. Which is a big relief, honestly. Conclusion: Aspirin can really help women with URSA have healthier pregnancies and more live births, without raising the risk of bleeding. The study think a big part of why it works could be linked to how it affects the gut microbiome and helps rebalance the immune system between mother and baby, like getting the Th17/Treg balance back on track. It’s an idea worth looking into more closely in future studies.Aspirin,Intestinal microbiota,Unexplained recurrent spontaneous abortion (URSA),Immune mechanism

[1] Moustakli E, Potiris A, Zikopoulos A, et al., 2025, Immunological Factors in Recurrent Pregnancy Loss: Mechanisms, Controversies, and Emerging Therapies. Biology, 14(7): 877. [2] Cai R, et al., 2025, Immune Treatment Strategies in Unexplained Recurrent Pregnancy Loss. American Journal of Reproductive Immunology, 93(2): e13939. [3] Yuan X, et al., 2025, Recurrent Pregnancy Loss: Crosstalk Between Immune Cells, Decidual Cells, and Cellular Autophagy. Reproductive Biology, 25(4): 101083. [4] Chen Y, et al., 2025, The Role of mTOR Signaling Pathway-Mediated Treg/Th17 Cell Imbalance in Recurrent Spontaneous Abortion. Journal of Reproductive Immunology, 172: 104744. [5] Tersigni C, Barbaro G, Castellani R, et al., 2024, Oral Administration of Bifidobacterium longum ES1 Reduces Endometrial Inflammation in Women with Recurrent Pregnancy Loss. Human Reproduction, 91(1): e13804. [6] Yao Y, Cai X, He D, et al., 2025, Short-Chain Fatty Acids Regulate T Cell Heterogeneity to Alleviate Recurrent Spontaneous Abortion. British Journal of Pharmacology, 182(23): 5762–5789. [7] Chen S, et al., 2024, Jianwei Shoutai Pills Alleviates Miscarriage by Modulating Gut Microbial Production of BAs and NLRP3-Inflammasome at the Maternal-Fetal Interface of Rats. Phytomedicine, 135: 156000. [8] Patki A, Kunjimoideen K, Sawankar S, et al., 2025, Expert Opinion on the Use of Probiotics in Recurrent Pregnancy Loss. Cureus, 17(3): e81056.