Meta-analysis of low molecular weight heparin to prevent recurrent placenta-mediated pregnancy complications. - Université de Bretagne Occidentale Access content directly
Journal Articles Blood Year : 2013

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

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 randomised controlled trials (RCTs) comparing low molecular weight heparin (LMWH) versus no LMWH for the prevention of recurrent placenta-mediated pregnancy complications. We identified six RCTs, including a total of 848 pregnant women with prior placenta-mediated pregnancy complications. The primary outcome was a composite of PE, birth of a SGA newborn (<10th percentile), placental abruption, or pregnancy loss >20 weeks. Overall, 67/358 (18.7%) of women on prophylactic LMWH had recurrent severe placenta-mediated pregnancy complications, as compared with 127/296 (42.9%) women with no LMWH [relative risk reduction 0.52 (95% CI 0.32-0.86) (p=0.01) (I(2) 69% indicating moderate heterogeneity)]. We identified similar relative risk reductions with LMWH for individual outcomes including any PE, severe PE, SGA <10th, SGA <5th, preterm delivery <37 weeks and preterm delivery <34 weeks with minimal heterogeneity. Low molecular weight heparin may be a promising therapy for recurrent, especially severe, placenta mediated pregnancy complications but further research is required.

Dates and versions

hal-00935578 , version 1 (23-01-2014)

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Marc A Rodger, Marc Carrier, Grégoire Le Gal, Ida Martinelli, Annalisa Perna, et al.. Meta-analysis of low molecular weight heparin to prevent recurrent placenta-mediated pregnancy complications.. Blood, 2013, epub ahead of print. ⟨10.1182/blood-2013-01-478958⟩. ⟨hal-00935578⟩
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