KEY POINTS:
An Auckland couple have had the first New Zealand baby in an international medical trial that offers hope to couples suffering multiple miscarriages.
Isabella Sophia Capunitan is now 6 months old, to the delight of parents Noemi and Ding. They had been trying to have a baby for
six years, with three unexplained miscarriages.
Their fortunes eventually turned around after they took part in a simultaneous trial in New Zealand, England and Scotland to test a combination of aspirin and heparin, an anti-blood-clotting agent, as a treatment for women with two or more consecutive pregnancy losses.
The study will compare whether women taking the drug combination have a more successful pregnancy than those just receiving intensive medical monitoring.
Of the five New Zealand women already taking part, two (including Mrs Capunitan) have successfully given birth and the other three are well past the "danger period", said lead researcher Dr Claire McLintock, of Auckland University's faculty of medical and health sciences. "We hope to have definitive results within a year."
As some of the women did not receive the drug regime, it was too early to be sure if the treatment was working, Dr McLintock said.
But Noemi and Ding Capunitan believe the drug combination helped to bring Isabella into their lives.
Mrs Capunitan lost her first baby after seven weeks. A year later, a second pregnancy also ended in miscarriage.
She was then advised to have removed fibroids and two benign cysts, which were thought to have contributed to the failed pregnancies.
She became pregnant for the third time, only to lose that baby as well. All miscarriages occurred six to eight weeks into the pregnancy.
Recurrent miscarriages are usually associated with medical problems in the parents such as hormonal deficiencies or the presence of autoimmune antibodies, but intensive testing revealed no answers. It also meant doctors could offer no specific treatment.
"We were told to just keep trying," said Mrs Capunitan, 39.
It was during this time that they were introduced to Dr McLintock. An emotional 18 months later, Mrs Capunitan successfully conceived again, and asked Dr McLintock to be involved in the Spin (Scottish Pregnancy Intervention) study.
Five weeks into her pregnancy, she started the daily regime of a low-dose aspirin and a nightly heparin injection.
"At first I was so nervous I was scared to go to work, to even go to the toilet, because that's how the miscarriages happened."
The regime continued until her 36th week. Isabella arrived on October 31, weighing a healthy 3.03kg.
Dr McLintock says that if proven successful, the combination of aspirin and heparin could bring joy to couples suffering recurrent miscarriages.
Aspirin is already commonly prescribed to women at risk of pre-eclampsia, a leading cause of maternal and infant death, while heparin, also an anticoagulant, is used in women with a history of blood clots and high antiphospho-lipid antibodies, which increase clotting. Some studies have suggested combining the two would be beneficial, but none have been head-to-head trials.
"You've really got to compare treatment with no treatment," said Dr McLintock. Researchers hope to recruit up to 300 women in all three countries.
In New Zealand, Dr McLintock hopes to get at least 15 more by the year's end, but would like more.
Women who have had two or more consecutive miscarriages before 24 weeks and are less than seven weeks' pregnant can volunteer. They will be randomly assigned the drug regime with intensive medical monitoring, or monitoring alone.
* For more information, visit nurture.org.nz or call (09) 373-7599, ext 89487.
Miscarriage
* One in four couples experience a miscarriage, usually before 20 weeks' gestation.
* One in 20 will have two or more consecutive losses.
* One in 100 will have three or more consecutive losses.
* Three in four cases of consecutive miscarriages cannot be explained.
