Effect of low-molecular-weight heparins on anti-Xa peak levels and adverse reactions in Chinese patients with recurrent spontaneous abortion: a single-center, observational study

Abstract

Objective To compare three commonly used low-molecular-weight heparins (LWMHs) in the treatment of recurrent spontaneous abortion (RSA) by evaluating the anti-Xa peak levels and adverse reactions. Methods In this single-center, observational study, we enrolled 310 patients with RSA in whom anti-Xa levels were measured during pregnancy. Patients were divided into three groups according to the LMWH they used: the nadroparin group, enoxaparin group and dalteparin group. We compared the peak anti-Xa levels and the coagulation status of each group, and analyzed the incidence of adverse reactions, including local allergy, liver and renal dysfunction, and the impact on platelet. Results Patients in the enoxaparin group had a higher anti-Xa peak level than those in the nadroparin group (0.80 ± 0.22 IU/ml vs. 0.61 ± 0.24 IU/ml; P < 0.0001), although most patients in the three groups reached the target concentration of anti-Xa. Furthermore, patients in the enoxaparin group had a more stable anti-Xa levels during pregnancy. In addition, patients in the nadroparin group had a higher rate of local allergy than those in the enoxaparin group (60.5% vs. 42.5%; P = 0.004) and those in the dalteparin group (60.5% vs. 33.3%; P = 0.002). Further examination by the type of local allergy indicated a dramatic difference in pruritus and induration between the nadroparin group and the other two groups. No difference was found in the incidence of liver and renal dysfunction and thrombocytopenia. Conclusion Compared with nadroparin and daltepatin, enoxaparin showed a better performance regarding anti-Xa levels and the incidence of adverse reactions in the treatment of RSA.

Fondaparinux Results in Similar Pregnancy Outcomes with Lower Adverse Reaction Rates Compared to Low Molecular Weight Heparin in Chinese Recurrent Miscarriage Women

“…For example, a prior study observes that the pregnancy success rate is 59% and 58% in women with RM receiving fondaparinux and enoxaparin; meanwhile, fondaparinux achieves comparable safety to enoxaparin (Winger and Reed 2009). Notably, another study illustrates that the pregnancy outcomes, including stillbirth, abortion, premature delivery, full-term delivery, and live birth rate, are not different between women with RM receiving fondaparinux and those receiving LMWH (Zhao et al 2021). Interestingly, this previous study finds that the total adverse reaction occurrence rate is lower in women with RM receiving fondaparinux (5.76%) compared with those receiving LMWH (19.12%) (Zhao et al 2021).…”

“…However, LMWH would unavoidably cause adverse reactions in women with RM, such as thrombocytopenia, allergic skin reactions, vaginal bleeding, and ecchymosis (Bai et al 2021, Chen et al 2022, Mu et al 2023, Nekooghadam et al 2023. At the same time, the option of anticoagulants apart from LMWH for women with RM is limited (Coomarasamy et al 2021, McNamee et al 2012.…”

Uso de anticoagulante no ciclo gravídico-puerperal e os efeitos adversos relacionados: revisão de literatura

“…Jacobson et al (2020), demonstraram que quando realizado terapia medicamentosa com HPBM, o risco de malformação congênita foi baixo, não houve um risco aumentado de mortalidade perinatal e nem risco de baixo peso no recém-nascido. Foram observados lesão hepática com discreta elevação de enzimas hepáticas, mas não foram observados insuficiência hepática grave, e houve raro casos de disfunção renal (Bai et al, 2021).…”

Effect of low dose prednisone on glucose metabolism levels in patients with spontaneous abortion: a single-center, prospective cohort study

“…The etiology of RSA is complicated, including anatomy abnormality, chromosome abnormality, infection, prethrombotic state (PTS), autoimmune disorders and endocrine disorders [3]. However, there is still a large proportion of RSAs which cannot be explained by the above factors and are de ned as unexplained recurrent spontaneous abortion (URSA) [4,5].…”