title: Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy.
abstract: OBJECTIVE
  To determine whether prophylactic low dose aspirin (LDA) alone or in combination with low-molecular-weight-heparin (LMWH) reduces the recurrence of adverse pregnancy outcome (APO).
  
  
  METHODS
  In this retrospective cohort study, 84 consecutive multiparous patients with a previous history of severe preeclampsia (sPE) and intrauterine growth restriction (IUGR) (<10%ile) were assigned to receive no treatment, LDA alone, or LDA and LMWH. Odds ratios were calculated from logistic regression models.
  
  
  RESULTS
  Combined LDA and LMWH significantly reduced the risk of developing IUGR in the index pregnancy (OR = 0.16, 95% CI: 0.03-0.98). Among women with antecedent sPE (n=52), combined treatment reduced APO in the index pregnancy (OR = 0.08, CI: 0.01-0.96), IUGR (OR = 0.02, CI: <0.01-0.46), and IUGR with sPE (OR = 0.08, CI: 0.01-0.96).
  
  
  CONCLUSIONS
  Combined treatment with LDA and LMWH is strongly protective against the development of APO in a cohort of women with antecedent APO.
authors.affiliation: University of Milano-Bicocca, Department of Obstetrics and Gynecology, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Urban
authors.forename: Patrizia
authors.initials: P
authors.lastname: Vergani
authors.forename: Roberta
authors.initials: R
authors.lastname: Tironi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ceruti
authors.forename: Emanuela
authors.initials: E
authors.lastname: Vertemati
authors.forename: Francesca
authors.initials: F
authors.lastname: Sala
authors.forename: Enrico
authors.initials: E
authors.lastname: Pogliani
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Lockwood
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Paidas
mesh_terms: D000328:Adult; D001241:Aspirin / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D004359:Drug Therapy, Combination; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D016017:Odds Ratio; D010298:Parity; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D016387:Women's Health
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin