Low-molecular-weight heparin and aspirin use in relation to pregnancy outcome in women with systemic lupus erythematosus and antiphospholipid syndrome: A cohort study.
OBJECTIVE
To relate anticoagulant use to pregnancy complications in women with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS).


METHODS
All ongoing pregnancies, 184, in two Dutch tertiary centers between 2000 and 2015.


RESULTS
LMWH and aspirin was prescribed in 15/109 SLE women without antiphospholipid antibodies (aPL), 5/14 with aPL, 11/13 with APS, 45/48 with primary APS. Main complications in the four treatment groups (no anticoagulant treatment, aspirin, LMWH, aspirin and LMWH) included hypertensive disorders of pregnancy (9.4%, 23.3%, 50%, 18.4%, respectively, p = 0.12) and preterm birth (16.7%, 34.3%, 75%, 36.8%, respectively, p < 0.001).


CONCLUSIONS
Maternal and perinatal complications occurred frequently, despite LMWH and aspirin use.
a Department of Obstetrics and Gynaecology , VU University Medical Center , Amsterdam , The Netherlands.
Carolien N H
CN
Abheiden
a Department of Obstetrics and Gynaecology , VU University Medical Center , Amsterdam , The Netherlands.|b Department of Rheumatology , Amsterdam Rheumatology and Immunology Center, VU University Medical Center , Amsterdam , The Netherlands.
Birgit S
BS
Blomjous
c Department of Rheumatology , University Medical Center Utrecht , Utrecht , The Netherlands.
Sylvia J
SJ
Kroese
b Department of Rheumatology , Amsterdam Rheumatology and Immunology Center, VU University Medical Center , Amsterdam , The Netherlands.
Irene E M
IE
Bultink
c Department of Rheumatology , University Medical Center Utrecht , Utrecht , The Netherlands.
Ruth D E
RD
Fritsch-Stork
d Department of Obstetrics and Gynaecology , University Medical Center Utrecht , Utrecht , The Netherlands.
A Titia
AT
Lely
a Department of Obstetrics and Gynaecology , VU University Medical Center , Amsterdam , The Netherlands.
Marjon A
MA
de Boer
a Department of Obstetrics and Gynaecology , VU University Medical Center , Amsterdam , The Netherlands.
Johanna I P
JI
de Vries
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000188:drug therapy*; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000139:chemically induced*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000139:chemically induced*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin
Antiphospholipid syndrome; aspirin; hypertensive disorders of pregnancy; low-molecular-weight heparin; systemic lupus erythematosus