Long-term dalteparin in pregnancy not associated with a decrease in bone mineral density: substudy of a randomized controlled trial
Article first published online: 21 MAY 2007
Journal of Thrombosis and Haemostasis
Volume 5, Issue 8, pages 1600–1606, August 2007
How to Cite
RODGER, M. A., KAHN, S. R., CRANNEY, A., HODSMAN, A., KOVACS, M. J., CLEMENT, A. M., LAZO-LANGNER, A., HAGUE, W. M. and FOR THE TIPPS INVESTIGATORS (2007), Long-term dalteparin in pregnancy not associated with a decrease in bone mineral density: substudy of a randomized controlled trial. Journal of Thrombosis and Haemostasis, 5: 1600–1606. doi: 10.1111/j.1538-7836.2007.02634.x
- Issue published online: 21 MAY 2007
- Article first published online: 21 MAY 2007
- Received 11 January 2007, accepted 30 April 2007
- low-molecular-weight heparin;
- randomized controlled trial
Summary. Background: The risk of decreased bone mineral density (BMD) with prophylactic dose long-term low-molecular-weight heparin (LMWH) is unknown. Objectives: We sought to determine whether long-term prophylactic dalteparin in pregnancy leads to loss of BMD. Patients/methods: Patients in a substudy of an ongoing multicenter randomized trial investigating the effect of antepartum dalteparin prophylaxis on pregnancy outcomes in thrombophilic pregnant women were randomized to either dalteparin 5000 U s.c. daily until 20 weeks and then 5,000 U s.c. q12 h until >37 weeks or to the control group. The primary outcome was absolute spine BMD at six weeks postpartum. Results: Of 77 patients eligible for the BMD substudy, 62 were analyzed. 33 patients received a mean of 212 days of dalteparin in the intervention group. 29 patients received a mean of 38 days of postpartum dalteparin in the control group. There was no difference in mean BMD between the intervention (1.11 g cm−2) and the control groups (1.14 g cm−2). Similarly, there was no difference in T-scores; the difference of −0.34 (95% confidence interval −0.93 to +0.25) in favor of the control group excludes a clinically important increase in fracture risk. Conclusions: Our results suggest that the use of long-term prophylactic dalteparin in pregnancy is not associated with a significant decrease in BMD.
Clinical trial registration: ISRCTN87441504 at http://www.controlled-trials.com.