Journal Club on the Run - Edition #30 (01.07.24)
Summary
Placenta-mediated complications including pre-eclampsia, placental abruption, late pregnancy loss and birth of small for gestational age infants are a leading cause of maternal and perinatal morbidity and mortality in high-income countries. Placental thrombosis is a frequently associated with placenta-mediated complications; hence anticoagulation has been considered a potential prophylactic therapy for high risk women..
This meta-analysis of individual patient data from 8 RCTs included women with a previous pregnancy complicated by pre-eclampsia, placental abruption, birth of an small for gestational age (SGA) baby (<10th centile), pregnancy loss after 16 weeks or two losses after 12 weeks. The primary outcome was a composite of early onset (<34 weeks) or severe pre-eclampsia, birth of an SGA infant (<5th centile), late pregnancy loss (after 20 weeks) or placental abruption leading to delivery.
Data from 963 women who were randomized to low molecular weight heparin (LMWH) vs no LMWH were analysed. The study population was mostly white (88%), mean age of 30.9 years; and 42% had a thrombophilia. LMWH did not significantly reduce the risk of recurrent placenta-mediated pregnancy complications in this population.