Biomaterial Database

Heparin-induced osteoporosis and pregnancy. 2008

Genevieve Le Templier, and Marc A Rodger

Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Canada.

OBJECTIVE Osteoporosis is the most common serious side effect of long-term unfractionated heparin use. Until recently, it was unknown whether long-term low-molecular-weight heparin was associated with any change in bone mineral density. With increasing long-term low-molecular-weight heparin use, for a variety of indications, this was an important knowledge gap. RESULTS We recently completed an a-priori planned substudy to assess the effect of low-molecular-weight heparin on bone mineral density in an ongoing multicenter multinational randomized trial designed to compare the effect of low-molecular-weight heparin prophylaxis on pregnancy outcomes in thrombophilic pregnant women. The results revealed that there is no significant difference in mean bone mineral density between a low-molecular-weight heparin prophylaxis group and a no prophylaxis group. The study was not adequately powered to detect differences in absolute fracture risk. CONCLUSIONS Recent results suggest that the use of long-term prophylactic low-molecular-weight heparin in pregnancy is not associated with a significant decrease in bone mineral density. Whether higher doses might be a risk factor for osteoporosis is still an unanswered question. It is also possible that subgroups are more susceptible. Overall, women should be reassured regarding the risk of osteoporosis associated with the use of prophylactic dose of low-molecular-weight heparin during their pregnancy.

UI	MeSH Term	Description	Entries
D010024	Osteoporosis	Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (OSTEOPOROSIS, POSTMENOPAUSAL) and age-related or senile osteoporosis.	Age-Related Osteoporosis,Bone Loss, Age-Related,Osteoporosis, Age-Related,Osteoporosis, Post-Traumatic,Osteoporosis, Senile,Senile Osteoporosis,Osteoporosis, Involutional,Age Related Osteoporosis,Age-Related Bone Loss,Age-Related Bone Losses,Age-Related Osteoporoses,Bone Loss, Age Related,Bone Losses, Age-Related,Osteoporoses,Osteoporoses, Age-Related,Osteoporoses, Senile,Osteoporosis, Age Related,Osteoporosis, Post Traumatic,Post-Traumatic Osteoporoses,Post-Traumatic Osteoporosis,Senile Osteoporoses
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011248	Pregnancy Complications	Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases.	Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D004305	Dose-Response Relationship, Drug	The relationship between the dose of an administered drug and the response of the organism to the drug.	Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260	Female		Females
D006495	Heparin, Low-Molecular-Weight	Heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism.	LMWH,Low-Molecular-Weight Heparin,Low Molecular Weight Heparin,Heparin, Low Molecular Weight
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D013923	Thromboembolism	Obstruction of a blood vessel (embolism) by a blood clot (THROMBUS) in the blood stream.	Thromboembolisms
D015519	Bone Density	The amount of mineral per square centimeter of BONE. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by X-RAY ABSORPTIOMETRY or TOMOGRAPHY, X RAY COMPUTED. Bone density is an important predictor for OSTEOPOROSIS.	Bone Mineral Content,Bone Mineral Density,Bone Densities,Bone Mineral Contents,Bone Mineral Densities,Density, Bone,Density, Bone Mineral