A1 Refereed original research article in a scientific journal
Prolonged low-molecular-weight heparin use during pregnancy and subsequent bone mineral density
Authors: Galambosi P, Hiilesmaa V, Ulander VM, Laitinena L, Tiitinen A, Kaaja R
Publisher: PERGAMON-ELSEVIER SCIENCE LTD
Publication year: 2016
Journal: Thrombosis Research
Journal name in source: THROMBOSIS RESEARCH
Journal acronym: THROMB RES
Volume: 143
First page : 122
Last page: 126
Number of pages: 5
ISSN: 0049-3848
DOI: https://doi.org/10.1016/j.thromres.2016.05.016
Abstract
Introduction: In contrast to unfractionated heparin (UFH), use of low-molecular weight heparin (LMWH) during pregnancy has not been reported to be associated with a significant decrease in bone mineral density (BMD). The aim of this study was to investigate whether long-term use of LMWH during pregnancy is associated with subsequent decrease in BMD or with increased number of osteoporotic fractures.Materials and methods: In this observational cohort study BMD was measured by dual energy X-ray absorptiometry (DEXA) 4-7 years after the last delivery in 152 women. Ninety-two women had prolonged LMWH-exposure during pregnancy - 75 as prophylaxis and 17 as treatment for venous thromboembolic event (VTE). Dalteparin and enoxaparin were the LMWH-preparations used. Sixty women without LMWH-exposure served as controls. A questionnaire about lifestyle factors and medical history was filled out by the subjects.Results: Lumbar spine BMD in the LMWH users was lower than that in the controls both in the prophylactic group (1.22 g/cm(2) vs. 1.27 g/cm(2); p=0.03), and in the treatment group (1.20 g/cm(2) vs. 1.27 g/cm(2); p= 0.07). BMD in femoral neck did not differ between the LMWH-users and controls. However, after adjusting for potential confounding factors, LMWH-exposure did not remain associated with decreased BMD in lumbar spine. Use of contraceptive pills was positively associated with BMD in lumbar spine. Incidence of osteopenia was 13% in the LMWH-group and 8% in the control-group, (p= 0.4). No osteoporosis or osteoporotic fractures were found.Conclusions: Prolonged use of LMWH during pregnancy was not associated with subsequent decrease in BMD, osteopenia, osteoporosis, or osteoporotic fractures. (C) 2016 Elsevier Ltd. All rights reserved.
Introduction: In contrast to unfractionated heparin (UFH), use of low-molecular weight heparin (LMWH) during pregnancy has not been reported to be associated with a significant decrease in bone mineral density (BMD). The aim of this study was to investigate whether long-term use of LMWH during pregnancy is associated with subsequent decrease in BMD or with increased number of osteoporotic fractures.Materials and methods: In this observational cohort study BMD was measured by dual energy X-ray absorptiometry (DEXA) 4-7 years after the last delivery in 152 women. Ninety-two women had prolonged LMWH-exposure during pregnancy - 75 as prophylaxis and 17 as treatment for venous thromboembolic event (VTE). Dalteparin and enoxaparin were the LMWH-preparations used. Sixty women without LMWH-exposure served as controls. A questionnaire about lifestyle factors and medical history was filled out by the subjects.Results: Lumbar spine BMD in the LMWH users was lower than that in the controls both in the prophylactic group (1.22 g/cm(2) vs. 1.27 g/cm(2); p=0.03), and in the treatment group (1.20 g/cm(2) vs. 1.27 g/cm(2); p= 0.07). BMD in femoral neck did not differ between the LMWH-users and controls. However, after adjusting for potential confounding factors, LMWH-exposure did not remain associated with decreased BMD in lumbar spine. Use of contraceptive pills was positively associated with BMD in lumbar spine. Incidence of osteopenia was 13% in the LMWH-group and 8% in the control-group, (p= 0.4). No osteoporosis or osteoporotic fractures were found.Conclusions: Prolonged use of LMWH during pregnancy was not associated with subsequent decrease in BMD, osteopenia, osteoporosis, or osteoporotic fractures. (C) 2016 Elsevier Ltd. All rights reserved.
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