January 1, 1989
Risks to the Fetus of Anticoagulant Therapy During Pregnancy
Key Result
No clinical data is available in the provided text, which consists only of the journal's editorial board information.
Structured PICO
Does anticoagulant therapy during pregnancy increase adverse fetal/infant outcomes?
P
Population
1,325 pregnancies associated with anticoagulant therapy from 186 reports
E
Exposure
Anticoagulant therapy (heparin, oral anticoagulants, or both)
C
Comparator
Normal population
O
Outcome
Adverse fetal/infant outcomes including death, prematurity and congenital malformationssafety
The previously reported high rate of adverse fetal outcomes with heparin during pregnancy is likely due to underlying maternal comorbid conditions rather than the drug itself.
Abstract
The use of anticoagulants during pregnancy is problematic because of the potential adverse effects to the mother and the fetus. Heparin does not cross the placenta, and thus, it was surprising that a recent report concluded that heparin therapy during pregnancy was as risky as oral anticoagulant therapy. Therefore, we performed a literature review of fetal/infant outcomes following anticoagulant therapy during pregnancy. We examined 186 reports which described fetal/infant outcomes in 1,325 pregnancies associated with anticoagulant therapy. The rates of adverse fetal/infant outcomes including death, prematurity and cogenital malformations following treatment with heparin, oral anticoagulants, or both were calculated. The previously described high rate of adverse fetal/infant outcomes with heparin-treated patients, could be accounted for by the frequent use of heparin in pregnancies with comorbid conditions independently associated with adverse outcomes and by reports of uncomplicated prematurity. After excluding such pregnancies, outcomes in heparin-treated patients are similar to the normal population.