Low-molecular-weight heparin and aspirin use in relation to pregnancy outcome in women with systemic lupus erythematosus and antiphospholipid syndrome: A cohort study

ABSTRACT

Objective: To relate anticoagulant use to pregnancy complications in women with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS). Methods: All ongoing pregnancies, 184, in two Dutch tertiary centers between 2000 and 2015. Results: LMWH and aspirin was prescribed in 15/109 SLE women without antiphospholipid antibodies (aPL), 5/14 with aPL, 11/13 with APS, 45/48 with primary APS. Main complications in the four treatment groups (no anticoagulant treatment, aspirin, LMWH, aspirin and LMWH) included hypertensive disorders of pregnancy (9.4%, 23.3%, 50%, 18.4%, respectively, p = 0.12) and preterm birth (16.7%, 34.3%, 75%, 36.8%, respectively, p < 0.001). Conclusion: Maternal and perinatal complications occurred frequently, despite LMWH and aspirin use.

KEYWORDS:

• Antiphospholipid syndrome
• aspirin
• hypertensive disorders of pregnancy
• low-molecular-weight heparin
• systemic lupus erythematosus

Acknowledgments

We would like to thank Prof. A.E. Voskuyl, MD, PhD, rheumatologist at VU University Medical Center for his input in the design of this study. We would like to thank Prof. R.H. Derksen, MD, PhD, rheumatologist at University Medical Center Utrecht for his effort setting up the database in the University Medical Center Utrecht. We would like to thank P.M. van de Ven, PhD, statistician at VU University Medical Center for his help with the statistical analysis. We would like to thank Dr. A. Thijs, internal medicine specialist at VU University Medical Center for his feedback on the manuscript. We also would like to thank M. Demissi and D.E. van Zanten, MD for their help entering data in the database. We would like to thank the Nationale Vereniging LE patiënten (NVLE), a Dutch SLE patient organization for supporting this study with a research grant.

Declaration of interests

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

The study was supported by a single grant from the “Nationale Vereniging LE patiënten (NVLE)”.

Additional information

Funding

The study was supported by a single grant from the “Nationale Vereniging LE patiënten (NVLE)”.