A 35-year-old woman with recurrent severe placenta-mediated pregnancy complications in her 2 pregnancies asks: Will low-molecular-weight heparin help prevent recurrent placenta-mediated pregnancy complications in my next pregnancy? We performed a meta-analysis of randomized controlled trials (RCTs) comparing low-molecular-weight heparin (LMWH) vs no LMWH for the prevention of recurrent placenta-mediated pregnancy complications. We identified six RCTs that included a total of 848 pregnant women with prior placenta-mediated pregnancy complications. The primary outcome was a composite of pre-eclampsia (PE), birth of a small-for-gestational-age (SGA) newborn (<10th percentile), placental abruption, or pregnancy loss >20 weeks. Overall, 67 (18.7%) of 358 of women being given prophylactic LMWH had recurrent severe placenta-mediated pregnancy complications compared with 127 (42.9%) of 296 women with no LMWH (relative risk reduction, 0.52; 95% CI, 0.32 to 0.86; P = .01; I-2, 69%, indicating moderate heterogeneity). We identified similar relative risk reductions with LMWH for individual outcomes, including any PE, severe PE, SGA <10th percentile, SGA <5th percentile, preterm delivery <37 weeks, and preterm delivery <34 weeks with minimal heterogeneity. LMWH may be a promising therapy for recurrent, especially severe, placenta-mediated pregnancy complications, but further research is required

Rodger, M., Carrier, M., Le Gal, G., Martinelli, I., Perna, A., Rey, E., et al. (2014). Meta-analysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications. BLOOD, 123(6), 822-828 [10.1182/blood-2013-01-478958].

Meta-analysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications

VERGANI, PATRIZIA;
2014-02-06

Abstract

A 35-year-old woman with recurrent severe placenta-mediated pregnancy complications in her 2 pregnancies asks: Will low-molecular-weight heparin help prevent recurrent placenta-mediated pregnancy complications in my next pregnancy? We performed a meta-analysis of randomized controlled trials (RCTs) comparing low-molecular-weight heparin (LMWH) vs no LMWH for the prevention of recurrent placenta-mediated pregnancy complications. We identified six RCTs that included a total of 848 pregnant women with prior placenta-mediated pregnancy complications. The primary outcome was a composite of pre-eclampsia (PE), birth of a small-for-gestational-age (SGA) newborn (<10th percentile), placental abruption, or pregnancy loss >20 weeks. Overall, 67 (18.7%) of 358 of women being given prophylactic LMWH had recurrent severe placenta-mediated pregnancy complications compared with 127 (42.9%) of 296 women with no LMWH (relative risk reduction, 0.52; 95% CI, 0.32 to 0.86; P = .01; I-2, 69%, indicating moderate heterogeneity). We identified similar relative risk reductions with LMWH for individual outcomes, including any PE, severe PE, SGA <10th percentile, SGA <5th percentile, preterm delivery <37 weeks, and preterm delivery <34 weeks with minimal heterogeneity. LMWH may be a promising therapy for recurrent, especially severe, placenta-mediated pregnancy complications, but further research is required
Si
Articolo in rivista - Articolo scientifico
Scientifica
recurrent pregnancy complications, low-molecular-weight heparin
English
822
828
7
Rodger, M., Carrier, M., Le Gal, G., Martinelli, I., Perna, A., Rey, E., et al. (2014). Meta-analysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications. BLOOD, 123(6), 822-828 [10.1182/blood-2013-01-478958].
Rodger, M; Carrier, M; Le Gal, G; Martinelli, I; Perna, A; Rey, E; de Vries, J; Gris, J; Chauleur, C; Molinari, N; Mares, P; Fabbro Peray, P; Quere, I; Lefrant, J; Haddad, B; Dauzat, M; van Pampus, M; Hague, W; Bezemerand, P; Joosten, J; Ruggenenti, P; Cetin, I; Pardi, G; Vergani, P; Acaia, B; Facchinetti, F; Sala, G; Bozzo, M; Rampello, S; Marozio, L; Diadei, O; Gherardi, G; Carminati, S; Remuzzi, G; Mannucci, P; Garneau, P; David, M; Gauthier, R; Leduc, L; Michon, N; Morin, F; Demers, C; Kahn, S; Magee, L
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/52237
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