Benefits and risks of low molecular weight heparin use on reproductive outcomes: A retrospective cohort study

Taiwan J Obstet Gynecol. 2022 Sep;61(5):812-817. doi: 10.1016/j.tjog.2022.05.015.

Abstract

Objective: Low molecular weight heparin (LMWH) has been given to reproductive-age women with various indications. This study aims to assess the benefits and risks of such use.

Materials and methods: We retrospectively reviewed data (n = 204) between Jan 2016 and May 2019. Logistic regression analysis was conducted to evaluate the correlation between indications and reproductive outcomes.

Results: LMWH use had higher odds of live birth in women less than 30 years of age (OR: 4.98; 95% CI = 1.13-21.98; p = 0.034) and with protein S deficiency (OR: 3.90; 95% CI = 1.77-8.59; p = 0.001). For the subgroup of recurrent pregnant loss, LMWH use was only advantageous to women with protein S deficiency (OR: 2.45; 95%:1.01-5.97; p = 0.048). Risks such as preterm delivery, small-for-gestational-age, placental abruption, antepartum/postpartum hemorrhage were not significantly increased among subgroups. Women treated with LMWH and who had successful live births (n = 171) had a slightly increased risk of postpartum hemorrhage compared to controls (n = 8058) during this period in our institution (2.9% vs 1.2%, p < 0.001).

Conclusion: LMWH administration produces a higher chance of live-birth to women younger than 30 years of age or with protein S deficiency. However, risk of postpartum hemorrhage is increased.

Keywords: LMWH; Protein S deficiency; Recurrent pregnancy loss; Reproductive outcomes.

MeSH terms

  • Female
  • Heparin, Low-Molecular-Weight / adverse effects
  • Humans
  • Infant, Newborn
  • Placenta
  • Postpartum Hemorrhage* / etiology
  • Pregnancy
  • Protein S Deficiency* / complications
  • Retrospective Studies
  • Risk Assessment

Substances

  • Heparin, Low-Molecular-Weight