PMID- 37726961 OWN - NLM STAT- MEDLINE DCOM- 20240318 LR - 20240318 IS - 1879-3479 (Electronic) IS - 0020-7292 (Linking) VI - 165 IP - 1 DP - 2024 Apr TI - Effect of low-molecular-weight heparin on placenta-mediated fetal growth restriction in a tertiary referral hospital: A 7-year retrospective cohort study. PG - 220-228 LID - 10.1002/ijgo.15098 [doi] AB - OBJECTIVE: To investigate the effect of low-molecular-weight heparin (LMWH) on placenta-mediated fetal growth restriction (FGR). METHODS: A cohort of 570 pregnant women diagnosed with placenta-mediated FGR were enrolled from January 1, 2015 through to December 31, 2021. A birth database, including demographic data, antenatal complications, and detailed delivery and newborn data, was created to collect variables from the Hospital Information System (HIS) Database. The unique personal registration number, assigned to each patient on first registration with HIS in the West China Second University Hospital, was used to link these patients. LMWH use was defined as at least 1-week prescription from diagnosis of placenta-mediated FGR. Pregnant women received LMWH (Enoxaparin 4000 IU/day) by self-administered subcutaneous injection only when they agreed and signed informed consent. Primary outcome was intrauterine fetal death after 20 weeks of pregnancy. Secondary outcomes included preterm birth (PB), Apgar score less than 7 at 1 min, admission to neonatal intensive care unit (NICU), and birth weight. Logistic regression analysis was conducted to compute adjusted odds ratio (aOR) with 95% confidence intervals (CI) for outcomes. RESULTS: After controlling for confounders, LMWH use was associated with a decreased risk of intrauterine fetal death (aOR 2.49, 95% CI 1.35-4.57, P = 0.003), PB before 37 weeks of pregnancy (aOR 3.35, 95% CI 2.14-5.23, P < 0.001), PB before 34 weeks of pregnancy (aOR 2.25, 95% CI 1.36-3.74, P = 0.002), Apgar score less than 7 at 1 min (aOR 2.25, 95% CI 1.36-3.74, P = 0.002), NICU admission (aOR 2.29, 95% CI 1.48-3.55, P < 0.001). Using LMWH increased the mean birth weight in PB before 32 weeks of pregnancy (mean +/- standard deviation [SD] 1126.4 +/- 520.0 g, P = 0.020), PB before 37 weeks of pregnancy (mean +/- SD 1563.9 +/- 502.7 g, P = 0.019), early-onset FGR (mean +/- SD 2125.2 +/- 665.7 g, P < 0.001), late-onset FGR (mean +/- SD 2343.4 +/- 507.9, P < 0.001), and non-severe FGR (mean +/- SD 2231.1 +/- 607.2 g, P < 0.001). CONCLUSION: Use of LMWH can significantly improve the fetal and neonatal outcomes among pregnant women with placenta-mediated FGR, particularly reducing the risk of intrauterine fetal death. CI - (c) 2023 International Federation of Gynecology and Obstetrics. FAU - Xu, Jinfeng AU - Xu J AD - Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China School of Medicine, Sichuan University, Chengdu, China. AD - The Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. AD - International Center for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. FAU - Tang, Yuxin AU - Tang Y AD - Department of Medical Record, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Peng, Bing AU - Peng B AD - Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. FAU - Zhang, Wei-Hong AU - Zhang WH AD - International Center for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. AD - School of Public Health, Universite libre de Bruxelles (ULB), Bruxelles, Belgium. FAU - Wang, Xiaodong AU - Wang X AUID- ORCID: 0000-0002-0164-1251 AD - Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. LA - eng GR - Sichuan Province Natural Science Foundation/ GR - 2022NSFSC0701/Sichuan Science and Technology Program/ GR - 202106240141/Chinese Scholarship Council/ PT - Journal Article DEP - 20230919 PL - United States TA - Int J Gynaecol Obstet JT - International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics JID - 0210174 RN - 0 (Heparin, Low-Molecular-Weight) SB - IM MH - Pregnancy MH - Female MH - Infant, Newborn MH - Humans MH - *Fetal Growth Retardation/etiology MH - Heparin, Low-Molecular-Weight/therapeutic use MH - Birth Weight MH - Retrospective Studies MH - Tertiary Care Centers MH - *Premature Birth/epidemiology/prevention & control MH - Placenta MH - Stillbirth MH - Gestational Age OTO - NOTNLM OT - fetal growth restriction OT - intrauterine fetal death OT - low-molecular-weight heparin OT - placental insufficiency OT - preterm birth OT - treatment EDAT- 2023/09/20 06:42 MHDA- 2024/03/18 06:42 CRDT- 2023/09/20 01:53 PHST- 2023/08/16 00:00 [revised] PHST- 2023/06/18 00:00 [received] PHST- 2023/08/18 00:00 [accepted] PHST- 2024/03/18 06:42 [medline] PHST- 2023/09/20 06:42 [pubmed] PHST- 2023/09/20 01:53 [entrez] AID - 10.1002/ijgo.15098 [doi] PST - ppublish SO - Int J Gynaecol Obstet. 2024 Apr;165(1):220-228. doi: 10.1002/ijgo.15098. Epub 2023 Sep 19.