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Although low\u2010dose aspirin (<jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content>) has a modest effect in preventing preeclampsia, antithrombotic interventions, <jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content> and low molecular weight heparin (<jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content>) have not definitively proven their effectiveness in women with placenta\u2010mediated pregnancy complications selected by previous pregnancy outcome alone. Given the heterogeneous aetiology of placenta\u2010mediated pregnancy complications, it is critical to stratify patients according to maternal and fetal characteristics and disease mechanisms rather than simply by pregnancy outcome, such as miscarriage. Such stratification could identify those who could benefit from antithrombotic interventions in pregnancy. We lack data on genome\u2010wide association studies, biomarkers and trials of interventions applied to specific homogeneous populations. Future studies should focus on elaborating different disease mechanisms and examining antithrombotic interventions in specific and more homogeneous groups, such as thrombophilic women with well\u2010characterized placenta\u2010mediated pregnancy complications, stratified by disease severity and pathological findings. Because of fetal safety concerns with new anticoagulants, the intervention should focus on heparins alone or in combination with <jats:styled-content style=\"fixed-case\">LDA<\/jats:styled-content>. Thus, placenta\u2010mediated pregnancy complications deserve precision medicine, defining disease by mechanism rather than outcome with interventions focused on a more personalized approach.<\/jats:p>","DOI":"10.1111\/bjh.12813","type":"journal-article","created":{"date-parts":[[2014,3,5]],"date-time":"2014-03-05T10:02:48Z","timestamp":1394013768000},"page":"585-599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Antithrombotic treatment for pregnancy complications: which path for the journey to precision medicine?"],"prefix":"10.1111","volume":"165","author":[{"given":"Ian A.","family":"Greer","sequence":"first","affiliation":[{"name":"Faculty of Health &amp; Life Sciences University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Brenner","sequence":"additional","affiliation":[{"name":"Department of Haematology and Bone Marrow Transplantation Rambam Health Care Campus Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Christophe","family":"Gris","sequence":"additional","affiliation":[{"name":"Department of Haematology University Hospital N\u00eemes and University of Montpellier N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2011.02.006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH04-01-0033"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01564.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03342.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.021"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1927"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2300"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-08-522623"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1614620"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1613894"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2004.01090.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.03.048"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181e9322a"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1538-7836.2003.00066.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.2011.01007.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3012"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.12.056"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-01-267252"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029660"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006780.pub3"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2011.04526.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004659.pub2"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(00)00084-0"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002859.pub2"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200209000-00004"},{"key":"e_1_2_9_27_1","unstructured":"Ferrazzi E.&Gris J.C.(2012)The evidence of the HAPPY trial is severely limited by the criteria and the methodology of recruitment. 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