{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:54:42Z","timestamp":1785884082290,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T00:00:00Z","timestamp":1570492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The objective of this study was to establish whether heparin improves the neonatal outcome of fetuses with suspected placental insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Before data extraction, the project was registered in the <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content> International Prospective Register of Systematic Reviews (registration number: <jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>42019117627). A systematic search was performed to identify relevant studies, using PubMed, <jats:styled-content style=\"fixed-case\">SCOPUS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> ISI<\/jats:styled-content> Web of Knowledge, and <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content> database for meta\u2010analysis. Suspected placental insufficiency was defined as either an estimated fetal weight or abdominal circumference below the 10th centile or when at least 2 of the following criteria were met: (1) abnormal biochemical markers, (2) sonographic evidence of abnormal placental morphology, or (3) abnormal uterine artery Doppler. Heparin in any commercial presentation was defined as the intervention. Mean difference (<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content>) by random effects model was used. Heterogeneity between studies was assessed using Cochran's <jats:italic>Q<\/jats:italic>,<jats:italic> H<\/jats:italic>, and <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1159 assessed studies, two were retained for analysis. The results showed a significantly higher birthweight (<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content> 365; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 236 to 494; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and a significant increase of gestational age at birth by 1\u00a0week in those women treated with heparin (<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content> 0.806; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.354 to 1.258; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). However, there were no significant differences in Apgar scores, neonatal admission, neonatal mortality, or composite neonatal morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with very high suspicion of placental insufficiency, heparin may increase fetal growth and prolong pregnancy. There is no evidence for a beneficial effect of heparin in reducing neonatal adverse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13730","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T21:22:55Z","timestamp":1568409775000},"page":"167-174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Heparin therapy in placental insufficiency: Systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0069-7640","authenticated-orcid":false,"given":"Edurne","family":"Mazarico","sequence":"first","affiliation":[{"name":"Fetal i+D Fetal Medicine Research Center BCNatal\u2014Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine August Pi i Sunyer Biomedical Research Institute (IDIBAPS) Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Molinet\u2010Coll","sequence":"additional","affiliation":[{"name":"Fetal i+D Fetal Medicine Research Center BCNatal\u2014Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine August Pi i Sunyer Biomedical Research Institute (IDIBAPS) Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raigam Jafet","family":"Martinez\u2010Portilla","sequence":"additional","affiliation":[{"name":"Fetal i+D Fetal Medicine Research Center BCNatal\u2014Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine August Pi i Sunyer Biomedical Research Institute (IDIBAPS) Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u University of Barcelona Barcelona Spain"},{"name":"Fetal Medicine and Therapy Research Center Mexico on behalf of the Iberoamerican Research Network in Translational, Molecular and Maternal\u2010Fetal Medicine Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Figueras","sequence":"additional","affiliation":[{"name":"Fetal i+D Fetal Medicine Research Center BCNatal\u2014Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine August Pi i Sunyer Biomedical Research Institute (IDIBAPS) Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u University of Barcelona Barcelona Spain"},{"name":"Center for Biomedical Research on Rare Diseases (CIBER\u2010ER) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000357592"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000253215.79121.75"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.566"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.014"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-0262"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-2-53"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2007.05.002"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2015.11.026"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13421"},{"key":"e_1_2_9_11_1","first-page":"359","article-title":"Expression of VEGF\u2010C and activation of its receptors VEGFR\u20102 and VEGFR\u20103 in trophoblast","volume":"16","author":"Dunk C","year":"2001","journal-title":"Histol Histopathol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000369363"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.119176"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31139-4"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(17)30065-8"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001673"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340802226359"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-3-54"},{"key":"e_1_2_9_21_1","unstructured":"HigginsJPT GreenS.Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. 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