Evidence map›Paper›PMID 42339498›Full record

SynthesisResearch and practice in thrombosis and haemostasis2026

Heparin to prevent recurrent placenta-mediated pregnancy complications in women with antiphospholipid syndrome: a systematic review.

Valérie L B I Jansen, Hanke M G Wiegers, Dorien M Salet, Thijs E van Mens, Saskia Middeldorp

Abstract readSystematic Review
In one paragraph

Synthesis in Research and practice in thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Valérie L B I JansenDepartment of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Reproduction and Development, Amsterdam University Medical Centers, University of Amsterdam, Netherlands.
Hanke M G WiegersDepartment of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Reproduction and Development, Amsterdam University Medical Centers, University of Amsterdam, Netherlands.
Dorien M SaletDepartment of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Reproduction and Development, Amsterdam University Medical Centers, University of Amsterdam, Netherlands.
Thijs E van MensDepartment of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Reproduction and Development, Amsterdam University Medical Centers, University of Amsterdam, Netherlands.
Saskia MiddeldorpDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: For women with antiphospholipid syndrome (APS) and placenta-mediated complications, the efficacy of heparin during subsequent pregnancies is uncertain. Objectives: This study systematically reviewed high-quality evidence on efficacy of low-molecular-weight heparin (LMWH) to prevent recurrent placenta-mediated pregnancy complications in women with APS. Methods: We searched Embase, MEDLINE, and CENTRAL to identify randomized controlled trials (RCTs) that assessed use of LMWH compared with any control in pregnant women with APS and previous placenta-mediated pregnancy complications (intrauterine growth restriction; birth of a small for gestational infant; preeclampsia; hemolysis, elevated liver enzymes, and low platelets syndrome; late fetal loss; and placental abruption). The primary outcome was recurrence of placenta-mediated pregnancy complications. Results: We identified 4007 records and included 2 RCTs. The TIPPS trial randomized eligible women to dalteparin or no dalteparin; 21 women with APS were included in this systematic review. The FRUIT trial randomized 32 women with APS to dalteparin and aspirin or aspirin only. The primary outcome of this systematic review occurred in 4 of 16 women in the intervention group of the FRUIT trial and in 3 to 6 of 16 women in the control group (risk difference, 6.25%; 95% CI, -22.3% to 34.8%; ranging to -12.5%; 95% CI, -44.3% to 19.3%, due to absent reporting on coinciding complications). The trials did not report on the outcome and population as defined in the current review in a manner that allowed pooling the primary outcome. Conclusion: There is no high-quality evidence from RCTs that demonstrates a beneficial effect of LMWH in women with APS and placenta-mediated pregnancy complications without a history of recurrent miscarriage.

Indexed as

AnticoagulantsAntiphospholipid SyndromeHeparin, Low-Molecular-WeightPlacenta DiseasesPregnancy ComplicationsDalteparinFemaleHumansPregnancyRandomized Controlled Trials as TopicTreatment OutcomeAnticoagulantsDalteparinHeparin, Low-Molecular-Weightantiphospholipid syndromeHELLP syndromeheparinlow-molecular-weight heparinpre-eclampsia

Identifiers

PMID42339498
PMCPMC13285347

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.