Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy

Int J Fertil Womens Med. 2007 Mar-Jun;52(2-3):59-67.

Abstract

Objective: To determine whether prophylactic low dose aspirin (LDA) alone or in combination with low-molecular-weight-heparin (LMWH) reduces the recurrence of adverse pregnancy outcome (APO).

Study design: In this retrospective cohort study, 84 consecutive multiparous patients with a previous history of severe preeclampsia (sPE) and intrauterine growth restriction (IUGR) (<10%ile) were assigned to receive no treatment, LDA alone, or LDA and LMWH. Odds ratios were calculated from logistic regression models.

Results: Combined LDA and LMWH significantly reduced the risk of developing IUGR in the index pregnancy (OR = 0.16, 95% CI: 0.03-0.98). Among women with antecedent sPE (n=52), combined treatment reduced APO in the index pregnancy (OR = 0.08, CI: 0.01-0.96), IUGR (OR = 0.02, CI: <0.01-0.46), and IUGR with sPE (OR = 0.08, CI: 0.01-0.96).

Conclusion: Combined treatment with LDA and LMWH is strongly protective against the development of APO in a cohort of women with antecedent APO.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aspirin / therapeutic use*
  • Cohort Studies
  • Confidence Intervals
  • Drug Therapy, Combination
  • Female
  • Fetal Growth Retardation / prevention & control*
  • Fibrinolytic Agents / therapeutic use*
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Odds Ratio
  • Parity
  • Pre-Eclampsia / prevention & control*
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Secondary Prevention
  • Women's Health

Substances

  • Fibrinolytic Agents
  • Heparin, Low-Molecular-Weight
  • Aspirin