Why the study?
Does Warfarin anticoagulation during pregnancy increase the risk of fetal complications compared to historical estimates?
Does Warfarin anticoagulation during pregnancy increase the risk of fetal complications compared to historical estimates?
Fetal risks associated with Warfarin during pregnancy remain high and have not been overestimated, reinforcing that it should be avoided if safer alternatives exist.
Answers are grounded in this paper and cite their sources.
Warfarin fetal risks exceed 1980 estimates; supports avoidance when alternatives exist but leaves optimal strategies open pending prospective data.
OBJECTIVES: To examine if fetal risks associated with Warfarin anticoagulation during pregnancy may have been over-estimated at the time the drug was contraindicated during pregnancy. METHODS: Seven case series with the same therapeutic objective for Warfarin anticoagulation published after 1980 were identified. The frequencies of fetal complications were calculated and compared with those of the 1980 compilation. RESULTS: The frequencies of embryopathy, stillbirths, and neonatal deaths were similar to the 1980 database, but higher with respect to spontaneous abortions (24.1 vs. 8.6%) and premature deliveries (13.9 vs. 4.6%), and lower regarding live births (73.3 vs. 83.7%). CONCLUSIONS: Fetal risks associated with Warfarin anticoagulation during pregnancy have not been overestimated. Warfarin should not be given in cases where other anticoagulants do not increase the risk for the expecting mother.
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Blickstein et al. (2002) studied this question.
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