ASA-LMWH aids those who've had preeclampsia.(Obstetrics)

VIENNA -- The use of low-molecular-weight heparin together with low-dose aspirin can improve pregnancy outcomes in women who previously had preeclampsia and low-birth-weight infants, Sergio Ferrazzani, M.D., reported.

Women with preeclampsia and low-birth-weight infants in their first pregnancy have double the recurrence rate of preeclampsia in their second pregnancy, compared with women who did not have preeclampsia previously. Infants of those subsequent pregnancies are at increased risk for fetal growth restriction and low birth weight. Data suggest that preeclampsia and fetal growth restriction might share one or more pathophysiologic mechanisms, said Dr. Ferrazzani of the Catholic University of the Sacred Heart, Rome.

An electronic database search of records from his hospital's high-risk pregnancy ward yielded data on 54 women with previous preeclampsia associated with low birth weight and/or intrauterine growth retardation who were negative for antiphospholipid antibody. The women had not been treated with aspirin during a previous pregnancy, he said at the 14th World Congress of the International Society for the Study of Hypertension in Pregnancy.

Of those 54 women, 23 gave birth during 1990-1996, when hospital policy called for thromboprophylaxis with low-dose (100 mg/day) aspirin alone (ASA); the 31 women who delivered during 1997-2003 were treated with the same daily dose of aspirin plus low-molecular-weight heparin (4,000 units subcutaneous enoxaparin).

Aspirin was prescribed from the 22nd day of the menstrual cycle and discontinued after 36 weeks' gestation. The low-molecular-weight heparin (LMWH) was prescribed after confirmation of a positive pregnancy test and continued until delivery.

The women were similar with regard to demographic and anthropomorphic characteristics. About 20% of the women in each group had chronic hypertension, and almost as many (17% in the ASA alone group and 19% in the ...