The effect of low-molecular-weight heparin on the birth weight in 28 to 34-week pregnancies complicated by intrauterine growth restriction.

Authors

  • Qurat Ul Ain King Abdullah Teaching Hospital Mansehra Author
  • Komal Imtiaz King Abdullah Teaching Hospital Mansehra, Health Department KPK, Pakistan Author
  • Maria Nawaz King Abdullah Teaching Hospital Mansehra, Health Department KPK, Pakistan Author

Keywords:

Intrauterine growth restriction, heparin, LMWH, birth weight

Abstract

Introduction: The use of low-molecular-weight Heparin (LMWH) in intra-uterine growth reduction is very common. However, its effect on the neonatal birth weight is not studied in our context. This study aims to compare the mean birth weight of neonates receiving low molecular weight heparin versus control in females presenting with intrauterine growth retardation.

Materials & Methods: This comparative cross-sectional study enrolled 100 women aged 18-40 years of parity <6 presenting during gestational age 28-34weeks presenting with IUGR from MCH Unit II, Department of Obstetrics & Gynecology, PIMS, Islamabad. After applying the selection criteria and obtaining approval, group 1 females were given LMWH i.e. 0.2-0.4ml given by subcutaneous injection along with parenteral nutrition while in group2, females were given 0nly parenteral nutrition i.e. control group. Then females were followed-up till delivery on 15th day basis. At time of delivery, birth weight of baby was noted.

Results: The mean age of women in group 1 was 30.10 ± 5.48 years and in group 2 was 29.06 ± 4.48 years. Mean gestational age was 30.49 ± 1.87 weeks. The mean birth weight of infants in group 1 was 2957.20 ± 177.76 grams, and in group 2 was 2663.7 ± 176.32 grams, with a p-value < 0.0001.

Conclusion: The mean birth weight of neonates receiving LMWH is higher as compared to control in females presenting with intrauterine growth retardation.

Author Biographies

  • Qurat Ul Ain, King Abdullah Teaching Hospital Mansehra

    Medical Officer, Department of Obstetrics & Gynaecology

  • Komal Imtiaz, King Abdullah Teaching Hospital Mansehra, Health Department KPK, Pakistan

    Medical Officer, Department of Obstetrics & Gynaecology

  • Maria Nawaz, King Abdullah Teaching Hospital Mansehra, Health Department KPK, Pakistan

    Medical Officer, Department of Obstetrics & Gynaecology

References

Villalaín, C., Herraiz, I., Akolekar, R., Figueras, F., Crispi, F., Rizzo, G., … Galindo, A. (2025). Clinical practice guidance for the management of fetal growth restriction: an expert review. The Journal of Maternal-Fetal & Neonatal Medicine, 38(1). https://doi.org/10.1080/14767058.2025.2526111

Zafar H, Naz M. Frequency of IUGR in pregnancy induced hypertension. Journal of University Medical & Dental College. 2012;3(2):8-13

Jacobwitz M, Kapse K, Ngwa J, De Asis-Cruz J, Wu Y, Donofrio MT, McDermott C, du Plessis A, Limperopoulos C, Andescavage N. Placental and Fetal In Utero Growth Among Fetuses With Congenital Heart Disease. JAMA Netw Open. 2025 Apr 1;8(4):e257217. doi: 10.1001/jamanetworkopen.2025.7217.

Baroutis D, Koukoumpanis K, Tzanis AA, Theodora M, Rizogiannis K, Bairaktaris D, Manios E, Pergialiotis V, Alexopoulos E, Daskalakis G. Low-Molecular-Weight Heparin in Preeclampsia: Effects on Biomarkers and Prevention: A Narrative Review. Biomedicines. 2025 Sep 24;13(10):2337. doi: 10.3390/biomedicines13102337.

Rajalakshmi A S, Anarghya Ananda Murthy, Sree Lakshmi K. Maternal thrombophilia and intrauterine growth restriction: A review of current evidence and clinical implications. Endocrine and Metabolic Science. 2025;19:100274. https://doi.org/10.1016/j.endmts.2025.100274.

Zhao P, Lu Y, Liu S, Zhang L, Chen C and Yang X (2025) Evaluating the efficacy of low-molecular-weight heparin in managing umbilical artery thrombosis during pregnancy: does it offer therapeutic benefits? Front. Med. 12:1540685. doi: 10.3389/fmed.2025.1540685

Yu, Y. H., Shen, L. Y., Zou, H., Wang, Z. J., & Gong, S. P. (2009). Heparin for patients with growth restricted fetus: A prospective randomized controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine, 23(9), 980–987. https://doi.org/10.3109/14767050903443459

Baroutis D, Koukoumpanis K, Tzanis AA, Theodora M, Rizogiannis K, Bairaktaris D, Manios E, Pergialiotis V, Alexopoulos E, Daskalakis G. Low-Molecular-Weight Heparin in Preeclampsia: Effects on Biomarkers and Prevention: A Narrative Review. Biomedicines. 2025; 13(10):2337. https://doi.org/10.3390/biomedicines13102337

Ephraums S, Dasgupta A, Korah S, Pasupathy D, Seeho S. A comparison of international clinical practice guidelines for postpartum venous thromboembolism prophylaxis. BMC Pregnancy Childbirth. 2025 Feb 12;25(1):150. doi: 10.1186/s12884-025-07246-3.

Shan D, Li T, Tan X, Hu YY. Low-molecular-weight heparin and preeclampsia - does the sword cut both ways? Three case reports and review of literature. World J Clin Cases. 2024 Mar 26;12(9):1634-1643. doi: 10.12998/wjcc.v12.i9.1634.

Sarmadi S, Mirzaian E, Nili F, Khalafrezaei F. Placental pathological findings and their association with maternal and fetal clinical outcomes: A cross-sectional study. Int J Reprod Biomed. 2024 Dec 2;22(10):771-780. doi: 10.18502/ijrm.v22i10.17662.

Cruz-Lemini M, Vázquez JC, Ullmo J, Llurba E. Low-molecular-weight heparin for prevention of preeclampsia and other placenta-mediated complications: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022 Feb;226(2S):S1126-S1144.e17. doi: 10.1016/j.ajog.2020.11.006.

Chen, J., Huai, J. & Yang, H. Low-molecular-weight heparin for the prevention of preeclampsia in high-risk pregnancies without thrombophilia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 24, 68 (2024). https://doi.org/10.1186/s12884-023-06218-9

Zhang Y, Guo S and Xu J (2025) Multifunctional applications and research advances of low molecular-weight heparin. Front. Pharmacol. 16:1585762. doi: 10.3389/fphar.2025.1585762

Singh KK, Gupta A, Forstner D, Guettler J, Ahrens MS, Prakasan Sheeja A, Fatima S, Shamkeeva S, Lia M, Dathan-Stumpf A, Hoffmann N, Shahzad K, Stepan H, Gauster M, Isermann B, Kohli S. LMWH prevents thromboinflammation in the placenta via HBEGF-AKT signaling. Blood Adv. 2024 Sep 24;8(18):4756-4766. doi: 10.1182/bloodadvances.2023011895.

Kleijer, M. E., Dekker, G. A., & Heard, A. R. (2005). Risk factors for intrauterine growth restriction in a socio-economically disadvantaged region. The Journal of Maternal-Fetal & Neonatal Medicine, 18(1), 23–30. https://doi.org/10.1080/14767050500127674

Published

01/01/2026

Issue

Section

Original Articles

How to Cite

The effect of low-molecular-weight heparin on the birth weight in 28 to 34-week pregnancies complicated by intrauterine growth restriction. (2026). MedPulse Spectrum, 1(2). https://jouex.com/index.php/medpulspect/article/view/30