title: [Long-term low-molecular-weight heparin therapy during pregnancy: is there a bone risk?].
abstract: Unfractionated heparin (UFH) and low-molecular-weight heparins (LMWH) are broadly used for the thromboprophylaxis during pregnancy. Long-term heparin therapy has raised concern about the risk of bone loss and osteoporotic fractures while pregnancy by itself favors osteoporosis. Experimental studies show a comparable effect of UFH and LMWH on bone formation while UFH has a more marked effect on bone resorption. Available clinical studies do not provide evidence of a difference between UFH and LMWH or among different LMWH on the bone risk. However, clinical studies show that bone loss observed with LMWH is not different from the physiological loss related to pregnancy, and osteoporotic fractures are associated with comorbidities or osteoporosis risk factors. LMWH represent the preferred alternative for thromboprophylaxis during pregnancy.
authors.affiliation: Médecine Interne, Paris, France. khalifa.pierre@wanadoo.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Khalifa
authors.forename: Lydia
authors.initials: L
authors.lastname: Marie-Scemama
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001862:Bone Resorption / Q000139:chemically induced; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D010012:Osteogenesis / Q000187:drug effects; D010024:Osteoporosis / Q000209:etiology*; D058866:Osteoporotic Fractures / Q000139:chemically induced / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy; D013923:Thromboembolism / Q000517:prevention & control; D013997:Time Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin