A prospective study of heparin-induced osteoporosis in pregnancy using bone densitometry

Am J Obstet Gynecol. 1994 Mar;170(3):862-9. doi: 10.1016/s0002-9378(94)70299-3.


Objective: Our purpose was to evaluate the subclinical occurrence of heparin-induced osteoporosis in pregnancy, by means of bone densitometry.

Study design: A prospective, consecutive cohort of 14 pregnant women requiring heparin therapy and 14 pregnant controls matched for age, race, and smoking status was identified by 20 weeks' gestation at a university medical center. Proximal femur bone density measurements were taken at baseline, immediately post partum, and 6 months post partum in the cases and controls. Vertebral measurements were also obtained on both groups immediately post partum and 6 months post partum. Bone density as a function of heparin dosing and duration was examined. Nonparametric statistical tests were used for all comparisons.

Results: Five of 14 cases (36%) had a > or = 10% decrease from the baseline proximal femur measurements to immediate postpartum values versus none of the 14 matched controls (p = 0.04). Mean proximal femur bone density measurements also decreased in the cases (p = 0.01); this difference continued to be statistically significant 6 months post partum (p = 0.03). No dose-response relationship could be demonstrated.

Conclusion: Heparin adversely affected bone density in about one third of exposed patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Bone Density*
  • Case-Control Studies
  • Dose-Response Relationship, Drug
  • Female
  • Femur / diagnostic imaging
  • Femur / physiology
  • Femur / physiopathology
  • Heparin / adverse effects*
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / physiology
  • Lumbar Vertebrae / physiopathology
  • Osteoporosis / chemically induced*
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / physiopathology
  • Pregnancy
  • Pregnancy Complications / chemically induced*
  • Pregnancy Complications / diagnostic imaging
  • Pregnancy Complications / physiopathology
  • Prospective Studies


  • Heparin