TY - JOUR
T1 - Meta-analysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications
AU - Rodger, M.A.
AU - Carrier, M.
AU - Le Gal, G.
AU - Martinelli, I.
AU - Perna, A.
AU - Rey, E.
AU - Vries, J.I.P.
AU - Gris, J.C.
PY - 2014
Y1 - 2014
N2 - A 35-year-oldwomanwith recurrent severe placenta-mediated pregnancy complications in her 2 pregnancies asks: Will lowmolecular- 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 5 .01; I2, 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. © 2014 by The American Society of Hematology.
AB - A 35-year-oldwomanwith recurrent severe placenta-mediated pregnancy complications in her 2 pregnancies asks: Will lowmolecular- 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 5 .01; I2, 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. © 2014 by The American Society of Hematology.
U2 - https://doi.org/10.1182/blood-2013-01-478958
DO - https://doi.org/10.1182/blood-2013-01-478958
M3 - Article
C2 - 24357725
SN - 0006-4971
VL - 123
SP - 822
EP - 828
JO - Blood
JF - Blood
IS - 6
ER -