Postpartum Bone Mineral Density in Women Treated for Thromboprophylaxis with Unfractionated Heparin or LMW Heparin

Ville Pettilä; Pekka Leinonen; Antti Markkola; Vilho Hiilesmaa; Risto Kaaja

doi:10.1055/s-0037-1612970

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2002; 87(02): 182-186
DOI: 10.1055/s-0037-1612970

In Focus

Schattauer GmbH

Postpartum Bone Mineral Density in Women Treated for Thromboprophylaxis with Unfractionated Heparin or LMW Heparin

Ville Pettilä

¹ Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Finland

,

Pekka Leinonen

² Departments of Obstetrics and Gynaecology, Helsinki University Central Hospital, Finland

,

Antti Markkola

³ Department of Radiology, Helsinki University Central Hospital, Finland

,

Vilho Hiilesmaa

² Departments of Obstetrics and Gynaecology, Helsinki University Central Hospital, Finland

,

Risto Kaaja

² Departments of Obstetrics and Gynaecology, Helsinki University Central Hospital, Finland

› Author Affiliations

Abstract

Summary

Venous thromboembolism remains an important cause of maternal mortality. In a randomised open study, 44 pregnant women with confirmed previous or current thromboembolism were randomised to receive either low-molecular-weight heparin, dalteparin (N = 21) once daily subcutaneously or unfractionated sodium heparin (UF heparin, N = 23) twice daily subcutaneously for thromboprophylaxis during pregnancy and puerperium. Bone mineral density (BMD) in the lumbosacral spine was measured with dual X-ray absorptiometry (DEXA) 1, 6, 16, 52 weeks and, if possible, 3 years after delivery. BMD values were also compared with those of healthy, delivered women (N =19).

Mean BMD of the lumbar spine was significantly lower in the unfractionated heparin group compared with the dalteparin and with the control groups (repeated measures ANOVA p = 0.02). BMD in the dalteparin group did not differ from BMD of healthy delivered women. Multiple logistic regression analysis revealed that therapy was the only independent factor influencing BMD at weeks 16 and 52. Therefore we recommend use of dalteparin instead of UF heparin for long-term thromboprophylaxis during and after pregnancy.

Keywords

Bone mineral density - osteoporosis - pregnancy - heparin - dalteparin

Full Text

References

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