Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study
<i>Background and Objectives</i>: Inherited thrombophilia (IT) increases the risk of adverse pregnancy outcomes, but the benefit of low-molecular-weight heparin (LMWH) prophylaxis remains debated. This study aimed evaluate the effect of LMWH by analyzing outcomes in women with IT who rec...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-06-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/7/1131 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849408958180098048 |
|---|---|
| author | Dragana Maglic Vesna Mandic-Markovic Zeljko Mikovic Rastko Maglic Radomir Anicic Milica Mandic |
| author_facet | Dragana Maglic Vesna Mandic-Markovic Zeljko Mikovic Rastko Maglic Radomir Anicic Milica Mandic |
| author_sort | Dragana Maglic |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Inherited thrombophilia (IT) increases the risk of adverse pregnancy outcomes, but the benefit of low-molecular-weight heparin (LMWH) prophylaxis remains debated. This study aimed evaluate the effect of LMWH by analyzing outcomes in women with IT who received LMWH versus those who did not and also compare pregnancy complication rates before and after inherited thrombophilia diagnosis. <i>Materials and Methods</i>: We conducted a retrospective case–control study including 276 pregnant women with inherited thrombophilia and prior pregnancy complications and 276 healthy pregnant controls on delivery. The main outcome was the incidence of complications: preterm rupture of membranes, oligohydramnios, fetal growth restriction, preterm delivery, stillbirth, HELLP syndrome, gestational hypertension, deep vein thrombosis, and recurrent pregnancy loss. The effect of LMWH was assessed by comparing complication rates among inherited thrombophilia patients who received therapy versus those who did not. <i>Results</i>: Women with IT were older, had higher BMI, delivered earlier, and had neonates with lower birth weight compared to controls. In current pregnancies, LMWH was associated with reduced rates of preterm delivery, fetal growth restriction, gestational hypertension, and recurrent pregnancy loss, especially in factor V Leiden carriers. LMWH had little effect on low-risk genotypes and was not independently associated with outcome reduction. <i>Conclusions</i>: LMWH prophylaxis should be reserved for high-risk women with IT. Routine use in all IT pregnancies is not justified and may cause unnecessary risks and costs. Early screening, risk stratification, and individualized care are essential to optimize outcomes. |
| format | Article |
| id | doaj-art-ae9ddac0df6748dc94e0d132c21b2a44 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-ae9ddac0df6748dc94e0d132c21b2a442025-08-20T03:35:38ZengMDPI AGMedicina1010-660X1648-91442025-06-01617113110.3390/medicina61071131Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control StudyDragana Maglic0Vesna Mandic-Markovic1Zeljko Mikovic2Rastko Maglic3Radomir Anicic4Milica Mandic5Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, SerbiaDepartment for High-Risk Pregnancies, University Clinic for Gynecology and Obstetrics “Narodni Front”, Kraljice Natalije 62, 11000 Belgrade, Serbia<i>Background and Objectives</i>: Inherited thrombophilia (IT) increases the risk of adverse pregnancy outcomes, but the benefit of low-molecular-weight heparin (LMWH) prophylaxis remains debated. This study aimed evaluate the effect of LMWH by analyzing outcomes in women with IT who received LMWH versus those who did not and also compare pregnancy complication rates before and after inherited thrombophilia diagnosis. <i>Materials and Methods</i>: We conducted a retrospective case–control study including 276 pregnant women with inherited thrombophilia and prior pregnancy complications and 276 healthy pregnant controls on delivery. The main outcome was the incidence of complications: preterm rupture of membranes, oligohydramnios, fetal growth restriction, preterm delivery, stillbirth, HELLP syndrome, gestational hypertension, deep vein thrombosis, and recurrent pregnancy loss. The effect of LMWH was assessed by comparing complication rates among inherited thrombophilia patients who received therapy versus those who did not. <i>Results</i>: Women with IT were older, had higher BMI, delivered earlier, and had neonates with lower birth weight compared to controls. In current pregnancies, LMWH was associated with reduced rates of preterm delivery, fetal growth restriction, gestational hypertension, and recurrent pregnancy loss, especially in factor V Leiden carriers. LMWH had little effect on low-risk genotypes and was not independently associated with outcome reduction. <i>Conclusions</i>: LMWH prophylaxis should be reserved for high-risk women with IT. Routine use in all IT pregnancies is not justified and may cause unnecessary risks and costs. Early screening, risk stratification, and individualized care are essential to optimize outcomes.https://www.mdpi.com/1648-9144/61/7/1131inherited thrombophiliapregnancy complicationslow-molecular-weight heparinfactor V Leidenfetal growth restriction risk stratification |
| spellingShingle | Dragana Maglic Vesna Mandic-Markovic Zeljko Mikovic Rastko Maglic Radomir Anicic Milica Mandic Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study Medicina inherited thrombophilia pregnancy complications low-molecular-weight heparin factor V Leiden fetal growth restriction risk stratification |
| title | Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study |
| title_full | Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study |
| title_fullStr | Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study |
| title_full_unstemmed | Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study |
| title_short | Impact of Inherited Thrombophilia on Pregnancy Complications and the Role of Low-Molecular-Weight Heparin Therapy: A Case–Control Study |
| title_sort | impact of inherited thrombophilia on pregnancy complications and the role of low molecular weight heparin therapy a case control study |
| topic | inherited thrombophilia pregnancy complications low-molecular-weight heparin factor V Leiden fetal growth restriction risk stratification |
| url | https://www.mdpi.com/1648-9144/61/7/1131 |
| work_keys_str_mv | AT draganamaglic impactofinheritedthrombophiliaonpregnancycomplicationsandtheroleoflowmolecularweightheparintherapyacasecontrolstudy AT vesnamandicmarkovic impactofinheritedthrombophiliaonpregnancycomplicationsandtheroleoflowmolecularweightheparintherapyacasecontrolstudy AT zeljkomikovic impactofinheritedthrombophiliaonpregnancycomplicationsandtheroleoflowmolecularweightheparintherapyacasecontrolstudy AT rastkomaglic impactofinheritedthrombophiliaonpregnancycomplicationsandtheroleoflowmolecularweightheparintherapyacasecontrolstudy AT radomiranicic impactofinheritedthrombophiliaonpregnancycomplicationsandtheroleoflowmolecularweightheparintherapyacasecontrolstudy AT milicamandic impactofinheritedthrombophiliaonpregnancycomplicationsandtheroleoflowmolecularweightheparintherapyacasecontrolstudy |