Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy.
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.
Urban
Gabriele
G
University of Milano-Bicocca, Department of Obstetrics and Gynecology, Italy.
Vergani
Patrizia
P
Tironi
Roberta
R
Ceruti
Patrizia
P
Vertemati
Emanuela
E
Sala
Francesca
F
Pogliani
Enrico
E
Triche
Elizabeth W
EW
Lockwood
Charles J
CJ
Paidas
Michael J
MJ
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
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin