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

Articolo
Data di Pubblicazione:
2014
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 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.
Tipologia CRIS:
03A-Articolo su Rivista
Elenco autori:
Rodger MA; Carrier M; Le Gal G; Martinelli I; Perna A; Rey E; de Vries JI; Gris JC;Low-Molecular-Weight Heparin for Placenta-Mediated Pregnancy Complications Study Group Collaborators (36) 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 di Ateneo:
MAROZIO Luca
Link alla scheda completa:
https://iris.unito.it/handle/2318/152105
Pubblicato in:
BLOOD
Journal
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