A prospective cohort study comparing achieved anti-factor Xa peak levels in pregnant and non-pregnant patients receiving therapeutic-dose low-molecular-weight heparin

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in pregnant women. Enoxaparin is a low-molecular-weight heparin used during pregnancy to treat or prevent VTE. In this study, we compare anti-factor Xa peak levels in pregnant and non-pregnant women, and explore the associati...

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Bibliographic Details
Published in:International journal of hematology 2020-07, Vol.112 (1), p.1-7
Main Authors: Aleidan, Fahad A. S., Aljarba, Ghada A., Aldakhil, Alaa A., Allehyani, Batol I., Yahia, Madona A., Alghtani, Nuorah E., Badri, Motasem, Alaklabi, Ali A., Alsuhaibani, Ahmad, Crowther, Mark A.
Format: Article
Language:English
Subjects:
Anticoagulants
Cohort analysis
Drug dosages
Health risk assessment
Hematology
Heparin
Levels
Medicine
Medicine & Public Health
Morbidity
Oncology
Original Article
Pregnancy
Thromboembolism
Weight
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Summary:Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in pregnant women. Enoxaparin is a low-molecular-weight heparin used during pregnancy to treat or prevent VTE. In this study, we compare anti-factor Xa peak levels in pregnant and non-pregnant women, and explore the association between anti-factor Xa (AFXa) peak levels and possible predictive parameters. Pregnant and non-pregnant patients received a therapeutic dose of enoxaparin every 12 h and three steady-state AFXa peak levels at 4-week intervals were collected. Sixty-eight patients (36 pregnant and 32 non-pregnant women) were enrolled. AFXa peak levels within therapeutic range (0.6–1.0 IU/ml) were achieved in the first measurement in 14 (38.9%) pregnant women compared to 21 (65.6%) non-pregnant women ( p  = 0.028). In the second anti-factor Xa measurement, 20 (55.6%) compared to 25 (78.1%) were within the reference interval ( p  = 0.008). Similar results were seen with the third measurement 20 (55.6%) compared to 26 (81.3%) ( p  = 0.003). In a mixed-effect repeated-measures model, pregnancy was associated with AFXa peak level (Mean difference = – 0.177; 95% CI – 0.349 to – 0.005, p  = 0.044). These findings suggest that further evaluation of a strategy involving more frequent monitoring of achieved AFXa levels could result in more effective anticoagulation.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-020-02873-2