PMID- 27236710
OWN - NLM
STAT- MEDLINE
DCOM- 20170413
LR  - 20170817
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 143
DP  - 2016 Jul
TI  - Prolonged low-molecular-weight heparin use during pregnancy and subsequent bone 
      mineral density.
PG  - 122-6
LID - S0049-3848(16)30375-9 [pii]
LID - 10.1016/j.thromres.2016.05.016 [doi]
AB  - 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) 4-7years 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 
      (1.22g/cm(2) vs. 1.27g/cm(2); p=0.03), and in the treatment group (1.20g/cm(2) 
      vs. 1.27g/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.
CI  - Copyright (c) 2016 Elsevier Ltd. All rights reserved.
FAU - Galambosi, Paivi
AU  - Galambosi P
AD  - University of Helsinki, Helsinki University Hospital, Department of Obstetrics 
      and Gynaecology, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: 
      paivi.galambosi@gmail.com.
FAU - Hiilesmaa, Vilho
AU  - Hiilesmaa V
AD  - University of Helsinki, Helsinki University Hospital, Department of Obstetrics 
      and Gynaecology, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: 
      hiilesmaa@gmail.com.
FAU - Ulander, Veli-Matti
AU  - Ulander VM
AD  - University of Helsinki, Helsinki University Hospital, Department of Obstetrics 
      and Gynaecology, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: 
      veli-matti.ulander@hus.fi.
FAU - Laitinen, Leena
AU  - Laitinen L
AD  - University of Helsinki, Helsinki University Hospital, Department of Obstetrics 
      and Gynaecology, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: 
      leena.laitinen@hus.fi.
FAU - Tiitinen, Aila
AU  - Tiitinen A
AD  - University of Helsinki, Helsinki University Hospital, Department of Obstetrics 
      and Gynaecology, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: 
      aila.tiitinen@hus.fi.
FAU - Kaaja, Risto
AU  - Kaaja R
AD  - University of Turku and Turku University Central Hospital, Kiinamyllynkatu 4-8, 
      20520 Turku, Finland. Electronic address: riskaa@utu.fi.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20160519
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Adult
MH  - Anticoagulants/administration & dosage/*adverse effects/therapeutic use
MH  - Bone Density/*drug effects
MH  - Bone Diseases, Metabolic/chemically induced
MH  - Cohort Studies
MH  - Female
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*adverse 
      effects/therapeutic use
MH  - Humans
MH  - Middle Aged
MH  - Osteoporosis/chemically induced
MH  - Osteoporotic Fractures/chemically induced
MH  - Pregnancy
MH  - Pregnancy Complications, Hematologic/*prevention & control
MH  - Venous Thromboembolism/*prevention & control
OTO - NOTNLM
OT  - Bone mineral density
OT  - Low-molecular-weight heparin
OT  - Osteopenia
OT  - Osteoporosis
OT  - Pregnancy
OT  - Risk factors
EDAT- 2016/05/30 06:00
MHDA- 2017/04/14 06:00
CRDT- 2016/05/30 06:00
PHST- 2016/02/23 00:00 [received]
PHST- 2016/04/29 00:00 [revised]
PHST- 2016/05/18 00:00 [accepted]
PHST- 2016/05/30 06:00 [entrez]
PHST- 2016/05/30 06:00 [pubmed]
PHST- 2017/04/14 06:00 [medline]
AID - S0049-3848(16)30375-9 [pii]
AID - 10.1016/j.thromres.2016.05.016 [doi]
PST - ppublish
SO  - Thromb Res. 2016 Jul;143:122-6. doi: 10.1016/j.thromres.2016.05.016. Epub 2016 
      May 19.