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Antithrombin improves fetal condition in women with severe pre‐eclampsia before 32 weeks of gestation; a randomized, double‐blind, placebo‐controlled trial
Author(s) -
Sameshima Hiroshi,
Kodama Yuki,
Ikenoue Tsuyomu,
Kajiwara Yayoi
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2007.00677.x
Subject(s) - medicine , gestation , placebo , eclampsia , fetus , gestational age , randomized controlled trial , birth weight , biophysical profile , obstetrics , pregnancy , relative risk , confidence interval , genetics , alternative medicine , pathology , biology
Aim: To see if antithrombin (AT) supplementation improved fetal outcomes in early onset (<32 weeks) severe pre‐eclampsia. Methods: A subgroup re‐analysis of an original randomized controlled trial of AT in pre‐eclampsia between 24 and 35 weeks of gestation was performed. Either AT (3000 IU/day, n = 42) or placebo (Albumin 582 mg/day, n = 42) were administered for 7 days. Fetal weight gain, biophysical profile score and fetal heart rate monitoring were evaluated during the treatment week and until delivery. Comparisons were performed by intent‐to‐treat and relative risk (RR) and 95% Confidence Intervals (CI) were obtained. Results: In each group, 27 women (64%) completed the allocated intervention. AT significantly decreased the worsening of the fetal biophysical profile score or fetal heart rate monitoring (RR 0.24, 95% CI 0.07–0.8), increased the incidence of estimated weight gain >15 g/day during the intervention week (3.1, 1.0–9.9), and prolonged gestational age to ≥34 weeks (3.6, 1.05–12.6), however infant mortality rates did not differ between the two groups. No adverse events related to AT were observed. Conclusions: Supplementation of AT preserves fetal biophysical condition and weight gain in early onset severe pre‐eclampsia and most likely prolongs pregnancies ≥34 weeks of gestation.