Low-molecular-weight heparin and aspirin use in relation to pregnancy outcome in women with systemic lupus erythematosus and antiphospholipid syndrome: A cohort study

Hypertens Pregnancy. 2017 Feb;36(1):8-15. doi: 10.1080/10641955.2016.1217337. Epub 2016 Sep 6.

Abstract

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).

Conclusion: Maternal and perinatal complications occurred frequently, despite LMWH and aspirin use.

Keywords: Antiphospholipid syndrome; aspirin; hypertensive disorders of pregnancy; low-molecular-weight heparin; systemic lupus erythematosus.

MeSH terms

  • Adult
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Antiphospholipid Syndrome / drug therapy*
  • Aspirin / adverse effects*
  • Aspirin / therapeutic use
  • Databases, Factual
  • Female
  • Heparin, Low-Molecular-Weight / adverse effects*
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Hypertension, Pregnancy-Induced / chemically induced*
  • Lupus Erythematosus, Systemic / drug therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Premature Birth / chemically induced*

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Aspirin