Risk factors and role of low molecular weight heparin in obstetric complications among women with inherited thrombophilia – a cohort study

Clavijo, Manuela; Mahuad, Carolina; Reparaz, Maria De Los Angeles Vicente; Aizpurua, María Florencia; Ventura, Adriana; Casali, Claudia

doi:10.1016/j.htct.2019.03.003

Cited by 6 publications

(9 citation statements)

References 34 publications

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“…On the basis of a review of the full texts of 133 studies, 111 studies were excluded, mainly because they were reviews, had no controls, or included individuals without inherited thrombophilia. Finally, 22 studies, including 12 cohort studies and 10 randomized controlled trials, were identified as eligible and included in the present systematic review and meta-analysis 13,17,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] (Figure 1). No eligible gray literature was found.…”

Section: Identification and Characteristics Of Studiesmentioning

confidence: 99%

“…[10][11][12] It is worth noting that, however, the effectiveness of LMWH in improving pregnancy outcomes, including reducing the proportion of APOs and increasing the ratio of live birth, is far from conclusive. [13][14][15][16][17] The inconsistency in the results of existing studies may be attributed to differences in study design, small sample sizes, and inconsistencies in the selection of exposure and control subjects. [13][14][15][16][17] In this situation, using integrated methods (e.g., meta-analysis) to assess the data provided in scientific literature would be helpful to determine the effectiveness of LMWH in improving pregnancy outcomes among women with inherited thrombophilia.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, LMWH has become the first choice of anticoagulants during pregnancy due to its superior safety 10–12 . It is worth noting that, however, the effectiveness of LMWH in improving pregnancy outcomes, including reducing the proportion of APOs and increasing the ratio of live birth, is far from conclusive 13–17 . The inconsistency in the results of existing studies may be attributed to differences in study design, small sample sizes, and inconsistencies in the selection of exposure and control subjects 13–17 .…”

Section: Introductionmentioning

confidence: 99%

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Low molecular weight heparin and pregnancy outcomes in women with inherited thrombophilia: A systematic review and meta‐analysis

Chen

Wang

Liu

et al. 2022

J of Obstet and Gynaecol

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Aim: To determine whether the use of low molecular weight heparin (LMWH) improves the pregnancy outcomes in women with inherited thrombophilia by conducting a meta-analysis of randomized controlled trials and observational studies. Methods: A systematic literature search of several databases was conducted through September 19, 2020 to identify relevant studies. The outcomes of interest included live birth and adverse pregnancy outcomes (APOs). The overall risk estimates were pooled using random-effects meta-analysis. Results: Ten randomized controlled trials and 12 cohort studies were included. In the meta-analyses of randomized controlled trials, the effectiveness of LMWH-treatment was found to be statistically significant in decreasing the risk of APOs (risk ratio [RR] = 0.76; 95% confidence interval [CI]: 0.61-0.95; p = 0.020), rather than in increasing the rate of live birth (RR = 1.12; 95% CI: 0.93-1.34; p = 0.230). In the meta-analyses of cohort studies, results showed that the use of LMWH was associated with a significantly higher proportion of live birth (RR = 1.86; 95% CI: 1.09-3.19; p = 0.020) as well as a significantly lower ratio of APOs (RR = 0.46; 95% CI: 0.31-0.69; p < 0.001) in women with inherited thrombophilia. Conclusions: The use of LMWH may have a potentially beneficial effect on reducing the risk of APOs and even increasing the live birth rate in women with inherited thrombophilia. Further well-designed clinical trials with large samples are needed to address the role of LMWH in improving pregnancy outcomes among pregnant women with inherited thrombophilia.

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Section: Identification and Characteristics Of Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low molecular weight heparin and pregnancy outcomes in women with inherited thrombophilia: A systematic review and meta‐analysis

Chen

Wang

Liu

et al. 2022

J of Obstet and Gynaecol

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“…The frequency of fetal loss is higher in women with highrisk inherited thrombophilia. The presence of antiphospholipid antibodies in pregnant women and their family history of obstetric complications were found to be associated with placenta-mediated pregnancy complications [7]. Antiphospholipid antibodies are anticardiolipin antibody, lupus anticoagulant and anti-beta2-glycoprotein I antibodies.…”

Section: Thrombophilia In Pregnancymentioning

confidence: 99%

“…Women with a venous thromboembolism in their history or a strong family history of thromboembolic events, as well as those with proven thrombophilia, have an indication for anticoagulant prophylaxis in the ante-and postpartum period [3]. Prophylactic treatment with low molecular weight heparin has a protective effect against obstetric complications, including miscarriage in patients with inherited thrombophilia [7].…”

Section: Antiplatelet and Anti-coagulant Treatment In Pregnancymentioning

confidence: 99%

Coagulation challenges in pregnancy: from thrombophilia involvement and management to the utility of thrombin generation monitoring

2020

Clinical and Experimental Obstetrics & Gynecology

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Experiencing pregnancy in the context of lupus and antiphospholipid syndrome: a grounded theory

Souza,

Barreto,

Teston

et al. 2024

Rev. Gaúcha Enferm.

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Objective: To understand the meanings attributed to pregnancy in the context of Lupus and antiphospholipid syndrome by women and healthcare professionals. Method: Qualitative research, using Symbolic Interactionism as a theoretical framework and Grounded Theory, a constructivist perspective. Data were collected between January and August 2022, through online interviews with 27 women with Lupus located on the social network Facebook and in-person or remote interviews with 12 healthcare professionals. Results: The theoretical model constructed has two categories: “Equal conditions, distinct experiences: experiencing the gestational process” shows that obstetric complications and lack of connection with healthcare professionals trigger negative meanings to the experience; and “Therapeutic management interfering in the attribution of meanings to the experience”, demonstrates that the way women interact with healthcare professionals and how they manage treatment favors a positive reframing. Final considerations: The meanings attributed to pregnancy are elaborated and modified according to the interpretation of previous and current experiences, healthcare trajectory and interactions with healthcare professionals. Previous guidance, planning, bonding and trust in healthcare professionals enable positive meanings, while obstetric complications, unqualified assistance and lack of bonding with professionals provide negative meanings.

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Risk factors and role of low molecular weight heparin in obstetric complications among women with inherited thrombophilia – a cohort study

Cited by 6 publications

References 34 publications

Low molecular weight heparin and pregnancy outcomes in women with inherited thrombophilia: A systematic review and meta‐analysis

Low molecular weight heparin and pregnancy outcomes in women with inherited thrombophilia: A systematic review and meta‐analysis

Coagulation challenges in pregnancy: from thrombophilia involvement and management to the utility of thrombin generation monitoring

Experiencing pregnancy in the context of lupus and antiphospholipid syndrome: a grounded theory

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