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.A., 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.
Citazione: | Rodger, M.A., 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. |
Tipo: | Articolo in rivista - Articolo scientifico |
Carattere della pubblicazione: | Scientifica |
Presenza di un coautore afferente ad Istituzioni straniere: | Si |
Titolo: | Meta-analysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications |
Autori: | Rodger, MA; Carrier, M; Le Gal, G; Martinelli, I; Perna, A; Rey, E; de Vries, JI; Gris, JC; Chauleur, C; Molinari, N; Mares; P; Fabbro-Peray, P; Quere, I; Lefrant, JY; Haddad, B; Dauzat, M; van Pampus, MG; Hague, WM; Bezemerand, PD; Joosten, JH; 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, PM; Garneau, P; David, M; Gauthier, R; Leduc, L; Michon, N; Morin, F; Demers, C; Kahn, SR; Magee, LA |
Autori: | |
Data di pubblicazione: | 6-feb-2014 |
Lingua: | English |
Rivista: | BLOOD |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1182/blood-2013-01-478958 |
Appare nelle tipologie: | 01 - Articolo su rivista |